Insights + Education
Currently there is no specific device value for the COVID-19 booster and or third COVID-19 vaccination. Assign the sixth character device value “U,” COVID-19 vaccine, when the additional dose is provided to the patient. A proposal for a new ICD-10-PCS code was presented by the Centers for Medicare and Medicaid at the September 2021 ICD-10…
November’s CDI Scenario covers neurogenic shock and spinal shock. A 58 year old male enters the ER after hitting his head.
Learn more about B3.7 (Control vs. More Specific Root Operations) and B4.1C as two important ICD-10 guideline changes for fiscal year 2022.
October’s CDI scenario covers pneumonia and COVID-19. A 60 year old male patient presents with COVID and worsening hypoxia.
In an unprecedented move, CMS has proposed in the 2022 Outpatient Prospective Payment System Rule to put back on the inpatient only list all 298 services that they had previously removed from the IPO list in CY 2021.
When will we implement ICD-11 for use on healthcare claims in the US? That’s a question everyone wants the answer to, but the true answer is – no one knows. However, when we know the answer on the following three key questions, we’ll be able to predict the implementation date in the US. Will the…
Make sure you are addressing these top documentation and coding compliance concerns. Risk-based review of evaluation and management codes (E/M): Appropriate application of FY21 E/M code guideline changes Telehealth visits (audio and visual vs. telephone only); Medicaid behavioral health telehealth Review providers with higher than 10% of visits in level 4 and 5, or outliers…
Make sure you are addressing these top documentation and coding compliance concerns. Risk-based review of inpatient DRG cases, examples include: RAC DRG targets; PEPPER targeted DRGs COVID related inpatient discharges Clinical indicators, cases at risk for clinical denials (e.g. Sepsis, CHF, ARF, severe malnutrition, encephalopathy) IP cases with only 1 MCC/CC code or HAC/PSI cases…
Learn more about codes 33995 and 33997, which are new to the 2021 Current Procedural Terminology (CPT).
The annual final rule from the Centers for Medicare and Medicaid Services (CMS) regarding the Inpatient Prospective Payment System (IPPS) MS-DRGs was issued on August 2, 2021. [1] This final rule is effective October 1, 2021. [2] It was proposed in April that 3,490 unspecified diagnosis codes currently designated as either CC or MCC would…