Coding Tips

COVID-19 Booster and Third Shot Vaccinations – November 2021 Coding Tip

By Marcy Blitch / November 18, 2021

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…

Two Important ICD-10 Guideline Changes for FY 2022 – October 2021 Coding Tip

By Marcy Blitch / October 21, 2021

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.

CMS to Reinstate Inpatient-Only List – September 2021 Coding Tip

By Marcy Blitch / September 22, 2021

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.

Medical Coding

ICD-11 Implementation Date

By Mary Stanfill / September 22, 2021
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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…

Reporting Percutaneous Ventricular Assist Device Insertion – August 2021 Coding Tip

By Marcy Blitch / August 18, 2021

Learn more about codes 33995 and 33997, which are new to the 2021 Current Procedural Terminology (CPT).

FY 2022 IPPS MS-DRG Final Rule Updates

By Mary Stanfill / August 9, 2021

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…

CY 2022 OPPS Proposed Rule

By Mary Stanfill / August 9, 2021

On July 19th the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Outpatient Prospective Payment System (OPPS) proposed rule. [1] After a comment period, the final rule will be published in November 2021. Notable changes proposed for CY 2022 include: A net increase in OPPS payment rates of 2.3% over…

New FY22 Code: Non-Traumatic Cardiac Injury

By Natalie Sartori / July 28, 2021

With the current ICD-10-CM code set, there is no specific code corresponding to non-traumatic myocardial injury. Given the high severity of illness typical of patients with non-ischemic myocardial injury, appropriate classification of these patients is paramount in terms of aligning appropriate diagnostic and treatment strategies while avoiding inappropriate approaches that would otherwise be suggested by…

New FY22 Code: Gastric Intestinal Metaplasia

By Natalie Sartori / July 15, 2021

Intestinal metaplasia (IM) occurs when cells in the tissues of the upper digestive tract, often in the stomach or esophagus, change and become more like cells from the intestines. Intestinal metaplasia in the esophagus is also called Barrett’s esophagus. Intestinal metaplasia is more common in people who have chronic acid reflux or gastroesophageal reflux disease (GERD). The…

Medical Coding

FY 2022 ICD-10-CM Updates

By Staff / July 13, 2021

Abnormal Findings on Neonatal Screening Currently there is only a single code to capture any or all types of newborn screenings that may have positive or abnormal results. The American Academy of Pediatrics requested expansion of category P09 Abnormal findings on neonatal screening, to specifically show which screening categories were abnormal. Table 1 shows the…