Advertisement

Main  |  Next »

Friday Sep 28, 2018

Use of hurricane-related ICD-10 codes is changing

The external cause codes for hurricane-related encounters have existed since ICD-10 was adopted. The important change, beginning Oct. 1, is that the National Center for Health Statistics provided clear definition on how to apply the codes correctly.


[Read More]


Posted at 02:45PM Sep 28, 2018 by Barbara Hays | Comments [0]

Thursday Aug 30, 2018

Coding for wound care: Is your EHR leading you astray?

Remember these tips for properly coding three common types of wounds.


[Read More]


Posted at 04:00PM Aug 30, 2018 by Betsy Nicoletti | Comments [0]

Thursday Aug 23, 2018

Medicare rolls out new cards to another group of states

The Centers for Medicare & Medicaid Services has started mailing new Medicare cards to beneficiaries who live in “Wave 5” states: Alabama, Florida, Georgia, North Carolina, and South Carolina. 


[Read More]


Posted at 02:15PM Aug 23, 2018 by Kent Moore | Comments [0]

Friday Aug 17, 2018

Proper diagnosis coding for malignant neoplasms

When selecting diagnosis codes for suspected, current, and personal history of malignant neoplasms, you need to follow specific rules for ICD-10.


[Read More]


Posted at 01:30PM Aug 17, 2018 by Betsy Nicoletti | Comments [0]

Friday Jun 22, 2018

Looking ahead to this year's new diagnosis codes

It’s not too early to start preparing for the annual round of ICD-10 diagnosis coding changes effective for dates of service on or after Oct. 1.


[Read More]


Posted at 09:00AM Jun 22, 2018 by Kent Moore | Comments [0]

Friday May 18, 2018

Avoid mistakes when coding for preventive medicine services

Selecting the appropriate code will hopefully facilitate payment for preventive services and reduce some unpleasant questions from patients.


[Read More]


Posted at 12:00PM May 18, 2018 by Betsy Nicoletti | Comments [0]

Thursday Aug 17, 2017

Are you ready to provide FAA BasicMed exams to pilots?

As of May 1, Congress changed the rules for how the pilots of small private planes may choose to receive medical clearance to fly. Instead of undergoing the full FAA-sanctioned physician exam, certain pilots can get certified by their personal physician.


[Read More]


Posted at 04:14PM Aug 17, 2017 by Barbara Hays | Comments [0]

Thursday Sep 15, 2016

Grace period for ICD-10 coming to an end

We’ve almost completed a full year of ICD-10-CM use. Congratulations! The world didn’t stop turning on its axis; the sun didn’t explode. Now, we are ready for the next hurdle related to ICD-10: The end of the “grace period” extended by the Centers for Medicare & Medicaid Services (CMS).

What was the “grace period?" It was a 12-month period, beginning Oct. 1, 2015, during which CMS processed and paid any Medicare claim submitted with a valid ICD-10 code that was at least within the family (the first three digits) of the diagnosis in question. This period is ending Sept. 30 of this year, after which CMS and its contractors will require the diagnostic codes you submit to reflect documentation and be specific to the patient and condition.

What codes should you be wary of using? “Unspecified,” “NOS,” and “not otherwise specified” codes will gain particular scrutiny from CMS. These codes will often have the digit “9” as the fourth or sixth character.  

How do you determine if your coding is safe? This answer is a two-parter. First, you need to evaluate which ICD-10 codes you are submitting most often on your claims. When I was in clinic, my family doctors thought they used certain codes often. But after I ran reports to show which ones they actually used, they were often surprised. Running a report of your top 25, 50, or 100 ICD-10 codes will help you determine how often you are using unspecified codes and where you need to concentrate on being more specific. Second, make sure you monitor your Medicare administrative contractor’s Local Coverage Determination (LCD) policies and CMS’s National Coverage Determination (NCD) policies(www.cms.gov). These polices list the covered diagnoses for specific services you may be performing, ordering or referring. Familiarize yourself with these policies. It will save you and your staff time and heartaches – and maybe a few claim denials, too.

Where can I go to learn more? CMS has published frequently asked questions and other resources about ICD-10(www.cms.gov).

– Barbie Hays, CPC, CPMA, CPC-I, CEMC, Coding and Compliance Strategist for the American Academy of Family Physicians


Posted at 11:20AM Sep 15, 2016 by David Twiddy | Comments [0]

Thursday Aug 11, 2016

It’s not too early to prepare for diagnosis code changes

Changes are coming to the ICD-10-CM code set. Effective with services provided on or after Oct. 1, ICD-10 diagnosis codes will update to the 2017 version.

The update will affect some of the diagnosis codes used in family medicine. For instance, one of the most significant changes is the addition of a new code, R73.03, for “Prediabetes.” Another example is coding for “familial hypercholesterolemia.” If you had to code that today, you would use E78.0 (Pure hypercholesterolemia). The 2017 version of ICD-10 replaces E78.0 with two new options:

•    E78.00 (Pure hypercholesterolemia, unspecified)
•    E78.01 (Familial hypercholesterolemia)

Similarly, ICD-10 is adding three new codes to report joint pain in the hands:

•    M25.541 (Pain in joints of right hand)
•    M25.542 (Pain in joints of left hand)
•    M25.549 (Pain in joints of unspecified hand)

These are just some of the changes relevant to family medicine. Crosschecking the diagnosis codes you use most often (e.g., the ones listed on your superbill) against the 2017 ICD-10-CM code set would be a good place to start in preparing for the update.

You can access the new ICD-10 code set and other related resources through the Centers for Medicare & Medicaid Services ICD-10 web site(www.cms.gov). The American Academy of Family Physicians also has ICD-10 resources on its web site, including AAFP Coding Flashcards for 2017.

Diagnosis code changes are coming. Are you ready?

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians


Posted at 10:56AM Aug 11, 2016 by David Twiddy | Comments [0]

Thursday Mar 03, 2016

You’ve made the switch to ICD-10 coding. Now what?

It’s been more than five months since ICD-10 became the required standard for coding and billing patient encounters in the United States, and the Centers for Medicare & Medicaid Services (CMS) wants to make sure your office is using ICD-10 not just correctly but productively. CMS has released the Next Steps Toolkit(www.cms.gov), a free resource that offers specific suggestions and recommendations in these areas:

Assessing your progress. Practices should compare current performance to a pre-ICD-10 baseline or establish a baseline for making future comparisons. Tracking key performance indicators such as rates of rejection and denial is the first step to improvement.

Addressing your findings. Systematically collecting and answering questions from staff and analyzing your clinical documentation and code selection as needed can help head off future problems and fix current ones.

Maintaining your progress. Physicians should make sure their systems capture annual ICD-10 updates, which take place in October.

For more information, visit CMS’s ICD-10 website(www.roadto10.org) and other resources(www.cms.gov), including this list of contacts(www.cms.gov), by state, for Medicare and Medicaid questions. 


Posted at 04:51PM Mar 03, 2016 by David Twiddy | Comments [0]

Main  |  Next »


CURRENT ISSUE

RECENT POSTS

SEARCH THIS BLOG


TOPICS

DISCLAIMER

The views expressed here do not necessarily reflect the opinions of FPM or the AAFP. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.

FEEDS