Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), announced there will be no delay to implementation for ICD-10-CM and PCS, which is scheduled October 1, 2014. She then encouraged everyone in the industry to work diligently toward a successful transition.
Tavenner made the statement at the annual Health Information Management Systems Society (HIMSS) conference, a year after she announced a 90-day comment period to determine if and how long a delay would be. The comments at that time ranged from killing ICD-10 completely to making no change from the originally planned date of 2013. Ultimately, the implementation was postponed by a year. Many providers and payers are using the extra year to better prepare.
Several organizations hoped Tavenner might announce another postponement at the HIMSS gathering, and some still advocated shelving the code set, but it looks like implementation is a done deal.
March 21st, 2013
The ear has three main parts: external, middle, and inner. These three parts work together so you can hear and process sounds. The outer ear is called the pinna (or auricle) and is made up of ridged cartilage covered by skin. After sound waves enter the outer ear, they travel through the ear canal and make their way to the middle ear, by vibrating the tympanic membrane. The tympanic membrane separates the outer ear from the middle ear and the ossicles. These are the three smallest bones in the human body. These three bones are named the malleus (hammer), the incus (anvil), and the stapes (stirrup). The vibrations are then conducted to the cochlea, which is part of the inner ear. It transforms sound into nerve impulses that then travel to the brain. The fluid-filled semicircular canals (labyrinth) attach to the cochlea and nerves in the inner ear. They send information on balance and head position to the brain. The eustachian tube drains fluid from the middle ear into the pharynx behind the nose.
In ICD-10-CM, the codes for Diseases of the Ear and Mastoid Process are located in Chapter 8. There are currently no guidelines for this chapter. Diseases of the external ear include codes for otitis externa, swimmer’s ear, and hematoma of the pinna. This is where the codes for cerumen impaction will also be found.
The section for the middle ear includes the codes for otitis media, one of the most common diseases in childhood. The two main types of otitis media are acute otitis media (AOM) and otitis media with effusion (OME). AOM is usually caused by bacteria, usually Streptococcus pneumoniae or Haemophilus influenza; but sometimes by a virus, like respiratory syncytial virus. OME occurs when there is thick or sticky fluid behind the eardrum in the middle ear, but there is no ear infection. Swelling of the lining of the Eustachian tube can be caused by many factors, including allergies, irritants (especially cigarette smoke), and respiratory infections. OME is most common in winter or early spring, but it can occur at any time of year. It can affect people of any age, although it occurs most often in children under age 2, according to the Center for Disease Control. There are many more codes in this section compared to ICD-9-CM due to laterality in the code set. Some examples include:
H65.22 Chronic serous otitis media, left ear
H66.001 Acute nonsuppurative otitis media without spontaneous rupture of ear drum, right ear
H66.23 Chronic atticoantral suppurative otitis media, bilateral
The section for the inner ear includes codes for otosclerosis, vestibular function disorders, and labyrinthitis. Documentation for auditory conditions should include the type of disorder and the ear, or ears, affected in order to assign the codes to the highest level of specificity available in ICD-10-CM.
October 10th, 2012
Unspecified ICD-9 codes should be avoided, according to Betty Hovey-Johnson, CPC, CPC-I, CPMA, CPC-H, CPC-D, AAPC’s ICD-10 director of development and training in a recent blog post for Getting Paid.
“It will become even more important to avoid unspecified codes once ICD-10 takes effect in 2014,” she said. “That’s because ICD-10 includes more granular codes, and payers will likely question physicians who aren’t taking advantage of this added specificity.”
Read the full article here.
September 19th, 2012
Now that ICD-10 is here for good, what does that mean for ICD-10 with superbills? Will things change and how much will they change after the 2014 implementation? Getting Paid is a practice management blog with a recent article highlighting AAPC.
“A coder or biller should ideally be mapping the codes one-by-one to determine how the changes will affect their particular practice,” stated Lisa Eramo, the author. “The General Equivalence Mappings (GEM) can be extremely helpful with this task. (AAPC) provides a three-step mapping process that coders can use in conjunction with the GEMs to cross-reference ICD-9-CM with ICD-10-CM.”
Read the full article here.
August 29th, 2012
With ICD-10-CM’s official date set at October 1, 2014 it’s time for most coding professionals to ramp again and get into that ICD-10 frame of mind. AAPC Director of ICD-10 development and training Betty Hovey, CPC, CPC-I, CPMA, CPC-H, CPCD recently wrote for Just Coding on the subject of neoplasm coding in ICD-10, and the similarities it presents to ICD-9.
“Neoplasm coding in ICD-10-CM is similar to the current ICD-9-CM coding,” she wrote. “Most benign and all malignant neoplasm codes are found in chapter 2 of ICD-10-CM, just as in ICD-9-CM. The ICD-10-CM manual includes many guidelines regarding the proper way to code them.”
Read the full article here.