Posts Tagged ‘ICD-9’

By Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CEMC, COBGC, CPCD, CCS-P

Is your organization delaying the implementation process.  Do you feel like the federal government will delay ICD-10 so you are procrastinating beginning the process? Are you risking delay and in some cases lost revenue in 2013?  ICD-10 seems like a long time away, but is it? Read more »

A recent update to the ICD-9-CM Official Guidelines for Coding and Reporting gives coders a choice of diagnosis codes to differentiate between the two types of influenza virus patients may present with this year. Read more »

Nearly 700 attendees join the AAPC in Norfolk, Va., for two-day event

NORFOLK, Va.—Oct. 12, 2009—The American Academy of Professional Coders’ (AAPC) Regional Conference last weekend drew the largest number of attendees ever in the history of regional conferences, with nearly 700 medical coders and health care professionals attending the two-day continuing education event, Oct. 8-10. The conference boasted more than 20 educational breakout sessions, covering topics such as Medicare research tips and traps, understanding fraud and ICD-9-CM updates for 2010.

“One conference, 700 attendees and almost 20 exhibitors all in one place—this conference was a complete success and exceeded our expectations,” said Reed Pew, AAPC President and CEO. “We first began hosting regional conferences two years ago, and with the response we received this weekend in Norfolk, we look forward to hosting future regional conferences.”

Pew kicked off the conference Friday morning, discussing the AAPC’s plans for 2010 and its growth rate. The AAPC’s membership drive is in full swing, aiming to reach 100,000 members by the end of 2010. Additionally, Pew announced two new specialty credentials in Hematology/Oncology and Podiatry, as well as a new core credential, the Certified Professional Medical Auditor credential (CPMA). Pew also spoke about the AAPC’s efforts in the successful delay of the final implementation date for ICD-10.

AAPC Vice President of Strategic Development, Deborah Grider, presented a general session on beginning preparation now for ICD-10. The session discussed preparation of implementation and analysis of ICD-10 for physician practices, hospital departments and health plans—small or large. The AAPC will offer on-site ICD-10 training for both providers and health plans beginning in 2010.

The AAPC will host its 2010 National Conference June 6-9 in Nashville, Tenn., and its 2010 Regional Conference Oct. 7-9 in Springfield, Mass.

Accurate payment for seasonal influenza (flu) virus vaccines requires precise coding. And to accomplish that, coders have to pay attention to details.

“Make sure you code correct route, correct product, correct ICD-9,” says Cathy Gray, RHIT, CCS, CPC-I, CCC, CGIC, with Henry Ford Health System in Detroit, in a recent issue of Pediatric Coding Alert.

Ask yourself the following questions:

1. Is the flu product the patient receiving preservative-free?

Preservative-free products cost more and, as such, reimburse at a higher rate. Report the wrong product code and your office loses money.

2. How old is the patient?

You should also base your product code selection on the patient’s age. Vaccines administered to individuals 3 years of age and older pay more than those given to children 6-35 months.

3. What came first, the shot or the spray?

The order in which you code services can affect how much your practice is reimbursed. If a patient receives an intranasal flu vaccine at the same time as an injectable vaccine, for example, code the injectable first.

4. Which vaccine administration code set should I use?

You should use the administration code set that best represents the patient’s age and physician (or other health care professional) counseling, advises Pediatric Coding Alert. Consult your payer to confirm whether it pays more for 90465 – +90468 than for the comparable 90471 – +90474 code set.

Read the complete Pediatric Coding Alert article, entitled “4 Coding & Billing Steps Boost Your Flu Prevention Pay by $38.”

By Angela “Annie” Boynton RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I

At this point, many are aware of the impending upgrades to ICD-10 and 5010/D.0/3.0.  Much has been touted about the costs.  It seems that the majority of health care leaders ask “How can we afford to implement ICD-10?” It’s a valid question especially when nationwide estimates are as high as $8 billion dollars to implement ICD-10.  Over the past few years many studies have been done that focus on the cost of implementation.  RAND Corporation, the Nolan Corporation and Price Waterhouse Coopers have all studied the fiscal impact of ICD-10 implementation. Read more »

By Julia Croly, CPC, CPC-P

With ICD-10-CM/PCS on the horizon, health plans will need to review their policies and procedures that work behind the scenes to administer benefits and adjudicate claims.  Does your health plan deny claims for pre-existing conditions?  Who in your health plan is responsible for the maintenance of the pre-existing list of conditions and their ICD-9-CM code(s)?

Let’s step back and look at what “pre-existing” is and what it means to members and health plans.

Read more »

In just a few short months—Oct. 1 to be exact—more than 350 new, revised or invalid ICD-9-CM code changes will take effect. Find out what experts in the field are saying is need-to-know information for Urology and Radiology coders.

Urology

Medical Coding Pro says new ICD-9 code 569.71 Pouchitis is for an infection of the diversionary bowl reservoir. For other diversionary problems, use new code 569.79 Other complications of intestinal pouch.

You’ll also find the October ICD-9 update clarifies acute kidney failure ICD-9 codes 584.5-584.9 and acute kidney failure after pregnancy with ICD-9 codes 639.3 and 669.3-669.34.

Radiology

Many coders will be happy to see that the October 2009 update revises the 793.0-793.7 range so that “abnormal” findings aren’t a requirement for using these codes.

Codes 793.5 Nonspecific (abnormal findings) on radiological and other examination of genitourinary organs and 793.6 Nonspecific (abnormal) findings on radiological and other examination of abdominal area, including retroperitoneum will help you explain medical necessity for review of such tests or for the performance of other diagnostic studies.

Codes 793.89 Other (abnormal) findings on radiological examination of breast and 793.99 Other nonspecific (abnormal) findings on radiological and other examination of body structure will have the same change, according to Coding News.

Meanwhile, code 793.82 Inconclusive mammogram has been revised to allow more accurate reporting. Use this code for services performed on or after Oct. 1 when additional testing is needed because of density, not an abnormality.

The Centers for Medicare & Medicaid Services (CMS) is revising Section 220.6 of the National Coverage Determinaton (NCD) Manual to reflect a new coverage framework for the use of F-18 flouro-D-glucose positron emission tomography (FDG PET) in determining initial and subsequent onocologic treatment strategies, as outlined in the NCD (CAG-00181R).

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CMS held a conference call presentation on 5010 Implementation with Chris Stahlecker and Lorraine Doo, CMS, Office of Information Services, as the speakers. During their presentations they made the following main points.

Need for 5010 Conversion

• More than 5 years since initial implementation, but 8 years since balloting of the current version
• Many situational and required rules did not fit business practices of the industry
• Industry relied too extensively on companion guides, limiting value of standards
• Many transactions were not implemented at all because of limited utility and value.

Why 5010 is an Improvement over 4010

• Includes structural and content oriented changes
• Incorporates more than 500 change requests
• Resolves ambiguities in situational rules
• Provides more consistency across transactions – most rules are the same throughout the suite
• Shortcomings have been addressed to increase value of transactions such as referrals and authorizations. Read more »

In response to recent human infections of Swine influenza A (H1N1) (swine flu) virus, the Department of Health and Human Services (HHS) issued a nationwide public health emergency declaration on April 26. The Centers for Disease Control and Prevention (CDC) is conducting case investigations, monitoring for illness in swine flu patients’ contacts, and enhancing surveillance to determine the extent of the virus.
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