Tag Archives: coder’s anatomy
Posted on 26. Sep, 2009 by .
If you think your hip is that thing jutting out at you in the mirror, your nomenclature needs a rehaul to ensure you’re nailing the correct codes. Coding for hip fractures and other procedures is easier when the coder is hip to the anatomy and terminology.
Common mistake: The average person refers to the prominent part of the pelvis that juts out just below the waistline (the iliac crest) as the hip. However, the hip portion of the pelvis is really about five inches below and is called the acetabulum, or “true hip.”
The ABCs of Hip Anatomy
Hip joint: Three areas of the pelvic structure form the acetabulum or the socket: the ilium, the ischium, and the pubis.
Femoral head: This is the “ball,” which is located in the upper end of the femur. The femoral head and the acetabulum are covered with a layer of cartilage that provides shock absorption and load distribution within the hip.
Posted on 24. Aug, 2009 by .
Do you know exactly what’s in the mediastinum? Your US coding depends on it.
Current payer policy on imaging guidance is especially strict, so you don’t want to miscode any ultrasound (US) services your ED physician provides. CPT Assistant has recently published a Q&A set that will help you get all the reimbursement you deserve for US service, without getting payback requests on improperly coded US.
Mediastinum Is Not Necessary for Chest US
CPT Assistant poses the question, “When reporting a chest US, is it necessary to include an examination of the mediastinum?”
No; however, if an examination of the mediastinum is indicated, it is included in chest US (76604, Ultrasound, chest [includes mediastinum], real time with image documentation), confirms Elijah Berg, MD, FACEP, CEO of MRSI, an ED coding and billing company in Woburn, Mass.
Impact: While the code descriptor does explicitly mention a mediastinum exam, you can report 76604 regardless of whether or not the physician documents examination of the area. (You cannot, however, report a mediastinum exam separately if the physician notes it during a chest US.)
Where is it? According to Dorland’s Dictionary, the mediastinum is: “The mass of tissues and organs between the sternum anteriorly and the vertebral column posteriorly and from the thoracic inlet superiorly to the diaphragm inferiorly. It contains the heart and pericardium, the bases of the great vessels, the trachea and bronchi, esophagus, thymus, lymph nodes, thoracic duct, phrenic and vagus nerves, and other structures and tissues.”
Use These CPT Designations on Soft-Tissue US …
Posted on 22. May, 2009 by .
OK, coders. If you aced Doctor’s Slang 101 and think you’re IT, it’s time for Round 2.
If you see these in an note, do you know what they mean?
- A’s and B’s
- Banana Bag
- ROMI or ”romied”
- Swiss Cheese
- Tet Syndrome
Posted on 27. Apr, 2009 by .
Acute Meckel’s diverticulitis is characterized by abdominal pain and tenderness of the type associated with appendicitis, but localized below or to the left of the umbilicus.
Surgical treatment includes resection of either the diverticulum or, in more serious cases, a larger portion of the bowel.
Rock & Roll Trivia Extra: Nirvana’s Kurt Cobain reportedly suffered from Meckel’s Diverticulum.
Posted on 24. Apr, 2009 by .
DIVER … WHAT? Make sure you stay ‘in the loop’ when it comes to diverticuitis and diverticulosis. I have trouble keeping them straight, so I know I’ll be using Coding News‘ search tool to find these definitions again.
Diverticulitis (562.11 [...without mention of hemorrhage, 562.13 [...with hemorrhage]) is inflammation of a diverticulum (an outpouching of a hollow or a fluid filled structure–”in this case, in the bowel), which can lead to peritonitis, perforation, fistula or abscess, among other conditions.
Diverticulosis (562.10 [...without mention of hemorrhage], 562.12 [...with hemorrhage]) is the presence of multiple diverticula in the colon, which may become inflamed or cause bleeding. Essentially, the diverticula are bulges that jut outward from weak spots in the bowel, which are probably the result of intraluminal pressure.
Interestingly, the American colon is more likely to have diverticulitis than colons from other countries, Dr. Bruce Rappaport told coders at AAPC’s Anatomy Expo. That’s because Americans typically eat less fiber than other people around the world.
Although diverticula are common in older patients and are most often asymptomatic, they may require surgical intervention.
Stay tuned to Coding News for more highlights from Dr. Rappaport’s colonoscopy tour, which he described as “kind of like those rides at Universal.”
Posted on 06. Apr, 2009 by .
When male babies are developing in the uterus, their testicles are located inside their abdomens. The testicles usually move down into the scrotum either just before or just after birth. Occasionally, a testicle doesn’t move down into the scrotum, and this condition is called cryptorchism (undescended testicle, 752.51).
Your physician can choose to treat undescended testicles with either a hormone HCG injection in the younger child or with a surgical procedure called an orchiopexy (54692).
Posted on 27. Mar, 2009 by .
“Proximal” describes where an appendage joins the body. Think of the word “proximity,” which means “nearness in place.”
“Distal” means a point on the appendage that’s furthest from the point of attachment to the body. Think “distance.”
Posted on 25. Mar, 2009 by .
Just when you thought your week was getting boring, it’s time for a Coder’s Anatomy Double-Take! Today’s look alikes, courtesy of Hazel Tank’s Word List, are:
ileum: the part of the small intestine located between the jejunum and the large intestine. Ref: ileus, ileac (when referring to the intestine).
ilium: the superior portion of the hip bone. Ref: iliac artery.
Posted on 23. Mar, 2009 by .
Today, let’s clear up the difference between malleolus and malleus, courtesy of medical transcriptionist Hazel Tank’s word list.
The malleolus is one of the rounded lateral projections of the bone at the ankle.
The malleus is the outermost of three small bones in the ear, Hazel clarifies.
Posted on 20. Mar, 2009 by .
For “supine,” picture the similar-sounding “soup in the navel.” (Yes, said navel is an “innie.”) If the soup can stay in the navel without spilling, the patient is supine, or face up. If not, the patient is prone, or face down.