Archive for 'ICD-10'

ICD-10: 1 Code for Malignant Tonsil? – Not Any More

Posted on 08. Jul, 2015 by .


Don’t forget additional code.

You’ve had it pretty easy up until now — reporting a malignant tonsil with just one code: 146.0 (Malignant neoplasm of tonsil).

You can forget about easy when ICD-10 goes into effect October 1 this year, because you’ll need to select from four malignant tonsil codes, plus choose a code from a host of additional codes that you must report secondarily.

Learn the Choices:

ICD-9 specifies that 146.0 is for tonsil, faucial, palatine, or not otherwise specified (NOS), and directs you to different codes for lingual or pharyngeal tonsil.

ICD-10 makes the same distinctions — and then some. Instead of one code for the palatine tonsils, you have the following choices: (more…)

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ICD-10: Ask for Clear Documentation for Reporting Acute on Chronic Respiratory Failure

Posted on 24. Jun, 2015 by .


Code choices will hinge on presence of hypercapnia or hypoxia.

Treating patients who have chronic conditions can change how an anesthesiologist provides care in some circumstances, and might even allow for additional reimbursement. One example is a patient undergoing a procedure who has been diagnosed with acute exacerbation of chronic respiratory failure.

ICD-9: Currently, providers have three diagnosis choices in this situation, depending on the presence of hypercapnia or hypoxia from the results of blood gas analysis (which you’ll need to acquire from the surgeon or other physician).

For acute exacerbation of chronic respiratory failure, you report 518.84 (Acute and chronic respiratory failure). (more…)

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ICD-10: Be Ready for 2 GERD K Codes in October

Posted on 12. Jun, 2015 by .


Rely on the note to get information you need to choose either K21.0 or K21.9.Rely on the note to get information you need to choose either K21.0 or K21.9.

If your office sees patients who complain of acid reflux and heartburn frequently, you will want to get comfortable with the new coding changes with ICD-10 in October.

ICD-9: You currently use ICD-9 530.81 (Esophageal reflux) on your gastroesophageal reflux disease (GERD) claims.

ICD-10: (more…)

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ICD-10: Associations Fear ICD-10 Transfer Might Trigger Massive Denials

Posted on 27. May, 2015 by .


End-to-end testing reveals potential problems.

If you have questions about the ICD-10 transition, you’re not alone. Specialty societies, including the American Medical Association (AMA), are waiting for answers, too.

The AMA was among 100 medical groups that wrote to the Centers for Medicare & Medicaid Services (CMS) on March 4 seeking responses to ICD-10 issues that they believe have not been appropriately addressed. Although the groups didn’t go so far as to request a delay to the Oct. 1 implementation date, they did express strong concerns about the transition in the 7-page letter to Acting CMS Administrator Andrew Slavitt.

Chief among the issues were the results of CMS’s end-to-end testing periods, which revealed claim acceptance rates in the 76 to 89 percent range. (more…)

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ICD-10: CMS Accepts 81 Percent of ICD-10 Test Claims

Posted on 14. May, 2015 by .


Biggest denial reason had nothing to do with diagnosis coding.

It appears that ICD-10 really will be implemented this year, with a recent Congressional hearing confirming that the government doesn’t plan to push back the new diagnosis coding system any further than it already has been—and with those plans full steam ahead, CMS revealed that its recent end-to-end testing period returned positive results.

The agency processed 14,929 test claims during the Jan. 26 to Feb. 3 testing period, from 661 participating providers. An overwhelming majority of claims—81 percent—were accepted through the system, and the remaining claims were rejected for three main reasons, as follows, according to the most recent statistics released by CMS: (more…)

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Coding Corner: 2 Clinical Rehab Examples to Get Your Feet Wet in ICD-10

Posted on 23. Apr, 2015 by .


Careful: Crosswalks can be your best friend — or worst nightmare.

ICD-10 codes are coming soon, and they’re a lot more detailed than ICD-9. Use the following examples to get a feel for the higher granularity you’re looking at for common rehab diagnoses.

1. Flaccid Hemiplegia

An OT documents a visit for a right-handed client with flaccid hemiplegia impacting the right side. “In ICD-9, the therapist could code the treatment diagnosis of 342.01 (Flaccid hemiplegia and hemiparesis affecting the dominant side),” says Jeremy Furniss, MS OTR/L, coding and payment specialist for the American Occupational Therapy Association (AOTA). “The ICD-10, however, looks at dominant and non-dominant as well as laterality, so the ICD-10 code is G81.01 (Flaccid hemiplegia affecting right dominant side). (more…)

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ICD-10: Still Feeling ICD-10 Defiant? CMS Responds

Posted on 08. Apr, 2015 by .


If you’re feeling hesitant to adapt to ICD-10, it’s time to start planning.

With just six months left until use of ICD-10 codes is mandatory, there are still some practices that are feeling more defiant than compliant. If you remain opposed to the ICD-10 transition, CMS offers a stark reality in its recent website FAQs, letting you know that you simply won’t be able to collect from the program if you turn your back on the new coding system.

If you don’t switch to ICD-10, your claim “cannot be processed,” the agency bluntly explains. Of course, this means that any services you submit to Medicare, Medicaid or any other payer covered by the HIPAA laws will have to transition to ICD-10 or else they won’t get reimbursed for their charges.

Myth: (more…)

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ICD-10: Keep Abreast of What CMS Plans for Future ICD-10 Testing

Posted on 30. Mar, 2015 by .


Here’s your chance to see how prepared you are for the new system. 

With the ICD-10 implementation date only months away, CMS is taking a four-pronged approach to ensuring that CMS and Medicare Fee-for-Service (FFS) practices are prepared. Read on to know what to expect, based on what Stacey Shagena with Medicare Contractor Management Group/CMS shared about Medicare’s testing plan during an MLN Connects call “Transitioning to ICD-10” on Nov. 5, 2014.

The four areas of focus for CMS are:  (more…)

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ICD-10: Right, Left, Bilateral Options Expand Carotid Artery Stenosis Choices

Posted on 18. Mar, 2015 by .


433.10 leads to more choices.

When your cardiologist performs angiography, catheterization, or stent procedures in the carotid artery for conditions such as stenosis, you’ll need more information to accurately report the condition under ICD-10.

You should be ready to implement these changes when ICD-10 goes into effect on Oct. 1, 2015.

ICD-9 offers two codes for carotid artery stenosis:

  • 433.10 — Occlusion and stenosis of carotid artery without cerebral infarction
  • 433.11 — Occlusion and stenosis of carotid artery with cerebral infarction.

But each of these codes grows to four different code choices under ICD-10. (more…)

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ICD-10: Screening Drug Test Orders Use Many Diagnoses

Posted on 25. Feb, 2015 by .


Get ready for new options later this year

When your lab performs a screening drug test, you can’t expect to get the same diagnosis code every time.

Instead, the reasons clinicians order a drug screen are as varied as the drugs themselves — and your code choices are about to get even more varied when ICD-10 goes into effect on Oct. 1.

Check Out These Crosswalk Options (more…)

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