Coding Tips

Critical Limb Ischemia – June 2021 Coding Tip

By Marcy Blitch / June 17, 2021

Critical limb ischemia, also known as chronic limb-threatening ischemia, is a clinical syndrome of peripheral artery disease of the lower limbs with ischemic pain at rest and ischemic tissue such as nonhealing ulcers or gangrene. Critical limb ischemia (CLI) does not happen overnight and does occur over time. Patients are at a much higher risk…

New FY22 Code: Vertebral Body Tethering

By Natalie Sartori / June 14, 2021

Overview: The fiscal year 2022 ICD-10-PCS code set updates [1] address the lack of a specific code for vertebral body tethering performed in the treatment of scoliosis. Scoliosis is a condition that manifests in a significant number of skeletally immature patients annually and is generally defined as an abnormal curvature of the spine greater than…

FY 2022 ICD-10-PCS Final Updates

By Natalie Sartori / June 14, 2021

On June 4th, 2021, CMS released the 2022 ICD-10 Procedure Coding System (ICD-10-PCS) updates. These codes will be applied beginning with discharges on October 1, 2021. The updated ICD-10-PCS codes contain 191 new codes, 62 revised titles, and 107 deleted codes, bringing the 2022 ICD-10-PCS code set total to 78,220. The leading code changes by…

UASI At A Glance

ICD-11 Post-Coordinated Code Clusters

By Mary Stanfill / May 24, 2021

ICD-11 introduces some great new features, including post-coordinated codes. Though you may not use these terms, we’re all familiar with pre-coordinated codes since all of the codes in the code sets we use today (including ICD-10-CM, ICD-10-PCS and CPT for example) are pre-coordinated. Pre-coordinated codes contain the pertinent information about a clinical concept in a…

CERT (Comprehensive Error Rate Testing) – May 2021 Coding Tip

By Marcy Blitch / May 20, 2021

Effective August 11, 2020, the Centers for Medicare & Medicaid Services resumed the Comprehensive Error Rate Testing program activities that were temporarily suspended in response to the public health emergency for the 2019-Novel Coronavirus (COVID-19) pandemic. CMS uses Comprehensive Error Rate Testing to verify Medicare Administrator Contractors are properly paying claims. CERT audits coding and…

FY 2022 IPPS MS-DRG Updates

By Natalie Sartori / May 12, 2021

On April 27th CMS released the 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] One of the most significant changes proposed for the V39 MS-DRG grouper logic includes changes to the severity level designation for unspecified codes. Recall for FY 2020, CMS proposed changes to the severity designation for 1,492 ICD-10-CM diagnosis codes which was…

FY 2022 IPPS ICD-10-PCS Updates

By Natalie Sartori / May 12, 2021

On April 27th CMS released the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] The proposal describes 127 new ICD-10-PCS codes, with a majority of the changes in the Surgery section. The Table below presents an outline of proposed changes to the surgery section by body system. In addition to the 79 new codes…

FY 2022 IPPS ICD-10-CM Updates

By Natalie Sartori / May 12, 2021

On April 27th CMS released the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] The Table below provides an outline of 153 proposed new ICD-10-CM codes, distributed across several chapters. Notable highlights for the proposed ICD-10-CM changes include new codes for: Immune effector cell associated neurotoxicity syndrome (ICANS) in category G92. ICANS is a clinical…

UASI Solutions

Leading Cause of Death in America – April 2021 Coding Tip

By Marcy Blitch / April 20, 2021

Medical claims denials in 2019 approached $9 billion. The denial rate in 2020 increased by 23%. Coding/billing errors accounted for approximately 15% of all denials. Specificity of coding was one of the reasons claims were denied. In 2019, stroke was the leading cause of death and killed approximately 140,000 Americans. Three Simple Questions to Ask…

UASI Solutions

Inpatient Only List – March 2021 Coding Tip

By Marcy Blitch / March 12, 2021

The inpatient only list is composed of procedures for which Medicare will only pay for when performed in the hospital inpatient setting. CMS has determined this list to be an area of concern in that it restricts patient choice when it comes to surgery. CMS has proposed to eliminate the list over the next three…