HFMA's Revenue Cycle Strategist newsletter answers a coding question every issue. Learn more about Revenue Cycle Strategist.

Invest in Ongoing Coder Education to Reap Long-Term Rewards

Eight practical strategies can move current staff into new coding roles.

Are You Ready for MACRA and MIPS: The New Healthcare Payment Reform

Value-based payment models, such as MACRA and MIPS, will require that coders capture the severity of illness as well as acute and chronic patient conditions.

Outpatient Coding Conundrums

When the codes on claims submitted by surgeons and outpatient surgery centers are not in agreement, one or both claims may be denied.

Coding for Smoking Cessation Services

There are no required guidelines on what type of smoking cessation should be administered, but the service should be documented and reported.

Coding Root Operations in ICD-10: Reiterate the Basics

How can coding managers help their coding professionals master root operations in ICD-10-PCS?

Understanding the Many Coding Changes Related to the FY18 IPPS

Coders should be aware of new codes for diabetics, heart failure patients, and new medical technologies.

ICD-10 Denials and Payment: Understanding the Relationship

Proactive, established processes to prevent denials and better manage appeals minimizes citation risks while promoting optimal, timely payment and compliance.

Opioid Pattern Variations Highlight Need for Careful ICD-10 Coding

When coders capture intent, type of use, and association manifestations for opioid abuse cases, they assist researchers in developing statistics that drive public health decisions.

Capturing Transitional Care and Chronic Care Management Appropriately
What is the difference between coding for transitional care management and chronic care management?

Coding for Antibiotic-Resistant Infections

What are the ICD-10 coding guidelines related to superbug infections and medication resistance?

New CMS Guidelines Impact Coders' Roles

How is the coder's role changing in the clinical validation process?

Coding for Conscious Sedation
How has coding for moderate sedation and conscious sedation changed?

New Hypertension Category Offers Specificity

What changes did ICD-10 make to hypertension coding?

Discharge Summaries and Clinical Coding: Wait or Risk?
How does the availability of a discharge summary impact the risk of coding denials and audits?

Coding for Prolonged Office Visits
If a provider spends longer than expected on a patient office visit, how can this time be captured and accounted for in payment?

New Respiratory Failure Coding Affects Payments
Coding changes for respiratory failure may signal a downgrade for the diagnosis from an MCC to a CC, potentially decreasing payment.

A 12-Month Plan for Coding Compliance
Healthcare organizations should evaluate five areas to ensure coding compliance.

Coding for Diabetes
ICD-10 offers more categories for coding diabetes than ICD-9 and requires more specific documentation from physicians for accurate coding of manifestations and relationships to other conditions.

Using CMS Resources to Detect Coding Problems
What are good data sources to help healthcare organizations reduce risk and financial loss?

Understanding Medical Necessity
What is medical necessity and how is it applied to evaluation and management services?

Coding for Chronic Conditions
Coders may find it challenging to determine what services fall under CMS’s chronic care management code, but fact sheets and a data warehouse offer assistance.

Understanding the Fate of Modifier 59
Will there ever be a need to report a modifier 59 with the addition of the new X modifiers?

Coding for Angiography
For superior and inferior mesenteric angiography, the catheter placement should be coded twice and the angiography should be coded twice.

Coding for Colonoscopies Based on Patient Risk
When coding for a high-risk colonoscopy, there must be a diagnosis of the condition that places the patient into that category.

Coding for Fluid Collection Depends on Aspiration Method
Documentation of the specific procedure is essential to proper code selection.

Defining Coders' Roles in CDI
CDI specialists and HIM professionals working in tandem with strong administrative support and physician champions make some of the most successful teams.

Another ICD-10 Delay? Now What?
Keep coders fresh on ICD-10 education by offering weekly review sessions to avoid the dreaded “use it or lose it” scenario that requires retraining later on.

Coding Changes for Removing Excess Ear Wax
Get clarification on the different coding procedures for ear wax removal and when it's appropriate to submit a separate service item.

ICD-10-CM Coding: Heed Definition Changes
The ICD-10 conversion will affect comparative data analysis of disease categories.

Leveraging Technology for ICD-10 Education
Web-based instruction is the most effective way to train remote staff in ICD-10 no matter where they are in the world.

Getting Ready for ICD-10 Diagnosis Codes
A good head start to ICD-10-CM readiness is including specific and complete diagnosis information in your records now.

Capturing Multiple Services with the Same CPT Code
It is sometimes difficult to recoup appropriate payment when the same CPT code must be used to capture multiple services.

Understanding Billing for Locum Tenens Physician Services
Medicare stipulates specific criteria for using the Locum Tenens Rule when temporary (i.e., locum tenens) physician is filling in for a physician who is out on vacation, sabbatical, or medical leave.

Coding for Complex Chronic Care Coordination Services
Although complex chronic care coordination services are not yet separately reimbursable by Medicare, capturing these codes and tracking payment will help promote broader reimbursement.

Defining New Versus Established Pediatric Patients
To ensure compliance and accurate payment, pediatric multispecialty group practices can use these tips to differentiate between new and established patients.

How to Choose ICD-10 Training for Coders
Learn how to choose ICD-10 training that can deliver the best organizational ROI.

Transitional Care Management
Transitional care management services associated with a patient’s move from an inpatient setting to a home setting may now be reimbursable if several requirements are met.

Direct Supervision Criteria: Nurse-Administered Therapeutic Injections
Following recommended practices will substantiate direct-supervision criteria if and when an insurer requests substantiating documentation or audits claims.

How Inaccurate Present-on-Admission Indicators Affect Payment
Close monitoring of the accuracy of POA indicators enables hospitals not only to monitor quality of care, but also to create safeguards and policies to help reduce the incidence of healthcare-acquired conditions.

Publication Date: Tuesday, December 12, 2017