Posts tagged ‘2012 codes’

September 22, 2011

Coding education comes to Texas!

If you haven’t gotten your coding education lately, including 2012 codes, book in one of my seminars in Houston, Dallas, or McAllen.

 

Advanced Coders, I’ll see you in November!

November 4, McAllen: Club At Cimarron, 1200 South Shary Road, Mission, TX 78572-7426
November 11, Dallas: Holiday Inn Express 6055 LBJ Freeway @ Preston, Dallas, TX 75240
November 28, Houston: Holiday Inn Houston Westchase 10609 Westpark Drive Houston, TX 77042

The advanced classes are approved for HCS-D CEUs and nursing continuing education credits.

Beginning coders, join me in October!

October 14, Houston: Holiday Inn Houston Westchase 10609 Westpark Drive Houston, TX 77042
October 17, Dallas: Holiday Inn Express 6055 LBJ Freeway @ Preston Dallas, TX 75240

The beginning courses are approved for nursing continuing education credits.

August 31, 2011

E.coli hits the 5th digit world

Effective Oct. 1, watch the E. coli codes …. they now need 5th digits.

041.49 is the code we are most likely to use.  Watch the use additional code instruction that is now attached to this group of codes.

Quick scenario: Your patient is being treated for a bladder infection caused by E. coli.

M1020: 595.0, acute bladder infection

M1022: 041.49, E. coli unspecified

August 18, 2011

All the new codes are here today!

My new codes webinar is Fridat Aug. 19 (TODAY!) at noon central time!

Learn everything you need to know about new codes and guidelines effective Oct. 1.

http://selmanholmanblog.com/2011/08/04/new-codes-seminar/#entry

August 16, 2011

I’m touring Texas!

Intermediate coders, get all the latest information on changes and the best coding education around. I’m

Highlights include:

  • Explain CMS guidance on sequencing.
  • Explain the relevance of OASIS C data items for diagnoses to payment.
  • Explain coding of diagnoses of infections, neoplasms, endocrine disorders such as diabetes, anemias, mental disorders, and the nervous system & sense organs.
  • Identify the differences between different kinds of ulcers.
  • Describe the purpose and appropriate use of V and E codes.
  • And tons more … including identifying new codes that will take effect October 1, 2011.

I will be in Dallas Aug. 24-25;  McAllen Aug. 31-Sept. 1; Houston, Sept. 7-8

IntermediateTourAugSep2011-1: Register and learn more!

August 4, 2011

New codes seminar!

My new codes seminar is rapidly approaching … come listen Aug. 19, 1-2:30pm CDT for a few highlights of the nearly 200 new and changed diagnosis codes for 2012 including:
• Expanded codes for E coli from one to 4 new codes.
• 40 new skin cancer codes that will add both case mix and non-routine supply points.
• New probably case mix codes for dementia without a specific underlying etiology will allow recognition of the presence or absence of behavioral issues and a change to what is described as a behavioral issue.
• Changes to the V code for history of pulmonary embolism.
• New complication codes associated with gastric band surgery, cystostomies and stem cell transplants.
• Specific V codes for acquired absence of joints when a prosthetic joint has been removed and replaced with a spacer.

NewCodesWebinar2011

July 27, 2011

Attack of the Vs

As usual, there are a large number of V code changes as the code year changes. A look at some that we might use …. appropriately and sparingly!

V12.5 Diseases of circulatory system: The subclassification at V12.5x now splits out venous thrombosis and pulmonary embolism. History of pulmonary embolism has its own code: V12.55.
V12.5 Diseases of circulatory system

      Excludes: history of anaphylactic shock (V13.81)
    V12.51 Venous thrombosis and embolism
      Excludes: pulmonary embolism (V12.55)
    V12.55 Pulmonary embolism

V19.1 Family history of other conditions, other eye disorders, now includes a family history of glaucoma code (V19.11)
V19 Family history of other conditions
    V19.1 Other eye disorders
      V19.11 Glaucoma
      V19.19 Other specified eye disorder

V40 Mental and behavioral problems now takes on Wandering in diseases (see the post on dementia!)
V40 Mental and behavioral problems

     V40.3 Other behavioral problems
       V40.31Wandering in diseases classified elsewhere
         Code first underlying disorder such as:
           Alzheimer’s disease (331.0)
           autism or pervasive developmental disorder (299.0-299.9)
           dementia, unspecified, with behavioral disturbance (294.21)
           intellectual disabilities (317-319)
       V40.39 Other specified behavioral problem

V54 Other orthopedic aftercare
     V54.8 Other orthopedic aftercare
       V54.82 Aftercare following explantation of joint prosthesis
           Aftercare following explantation of joint prosthesis, staged procedure
           Encounter for joint prosthesis insertion following prior explantation of joint prosthesis

V55 Attention to artificial openings: Note the new exclusions because of the new cystostomy complication codes
V55 Attention to artificial openings
Excludes: complications of external stoma (519.00-519.09, 569.60-569.69, 596.81-596.83, 997.49, 997.5)

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July 18, 2011

Cystostomy gets its codes … about time!

We’ve known for a long time that there should be more specific cystostomy codes, and the 2012 code set is finally helping us out.

596.8 is now 596.8x … a subclassification dealing with cystostomy infections and complications. Until Oct. 1, we will still be forced to code cystostomy infections with the vague 997.5, Urinary complications. After that, it’s a bonanza of 596.8x codes, and I think that they will be case-mix.

Don’t forget to scan documentation for the specific organism or reason for infection with 596.81, Infection of cystostomy.

Important: You cannot code V55.5, Attention to cystostomy, when there is an infection or complication. Ever.

Specifics of the new codes:
596.81 Infection of cystostomy
Use additional code to specify type of infection, such as:
abscess or cellulitis of abdomen (682.2)
septicemia (038.0-038.9)
Use additional code to identify organism (041.00-041.9)
596.82 Mechanical complication of cystostomy
Malfunction of cystostomy
596.83 Other complication of cystostomy
Fistula
Hernia
Prolapse
596.89 Other specified disorders of bladder
Bladder hemorrhage
Bladder hypertrophy
Calcified bladder
Contracted bladder

July 14, 2011

Will 294.20 and 294.21 take over as main dementia codes?

Two of the code set that go live Oct. 1 are new dementia codes 294.20, Dementia, unspecified, without behavioral disturbance
(Dementia NOS), and 294.21, Dementia, unspecified, with behavioral disturbance (This code includes dementia with Aggressive behavior, Combative behavior, or Violent behavior.

We have been coding with 294.10 and 294.11, which indicate Dementia in conditions classified elsewhere either with (.10) or without (.11) behavioral disturbance.

There are no Code First, or Code Underlying commands for the new 294.2x codes, so they hold an advantage that they shouldn’t be manifestation codes like the 294.1x codes. This means the 294.2x should be valid when you don’t know the disease causing the dementia, but  you have the dementia diagnosis.

It’s hard to say how much these new codes will “take over” the 294.1x codes, but hopefully, they will reduce the coding of the more vague 294.8 (Other persistent mental disorders due to conditions classified elsewhere).

Note: If your patient wandered off because of the dementia, 294.11 may have been your code, but Wandering off has been stripped from that code. See if Wandering in conditions classified elsewhere (V40.31) might describe your patient’s condition.

June 30, 2011

New codes quiz time

It’s that time of year … the final new code lists are out, and we need to start learning. Here are some fill-in-the-blank to help you learn new codes: (Answers at the bottom)

1. Look up this main term to see changes to 416.8

2. You should use one or two additional codes (if you have documentation) with this new Infection of cystostomy code

3. Category 539 deals with complications of these procedures

4. Acquired absence of a joint now has this subcategory

5. Several codes, including chronic pulmonary embolism (416.2) and pulmonary embolism and infarction (415.1) now have excludes notes for these types of codes

6. Other infections with the central _____ catheter has new codes

7. This code now deals with aggressive behavior in dementia

8. Influenza codes in categories 487 and ___ have gotten more specific

9. *Local* infection due to central venous catheter is coded here

10. This chapter received a new title this year

11. There are more than 10 new codes and 20 revisions for this eye disease

12. NCHS’s correction addendum swapped out V54.81 with V54.82 when coding this V58 subcategory

13. V40.31, Wandering in diseases classified elsewhere, excludes Alzheimer’s and this symptom often association with Alzheimer’s

14. Complications codes are getting more complicated. Don’t code 596.8x with this urinary complications code

15. When coding some atherosclerosis codes, watch the use additional code note on some codes in this category

16. Pelvic fractures (808.5x) now have specificity for open or ______

17. This phrase is now used to describe the previously known “mental retardation”

18. For skin cancer codes, a fifth-digit of 2 designates squamous cell _____

More to come on new codes, but if you’re looking for the complete Index and Tabular listings, as well as the errata, go to this NCHS list.

 

1. hypertension; 2. 596.81; 3. bariatric; 4. V88.2; 5. personal history; 6. venous; 7. 294.21; 8. 488; 9. 999.93; 10. five; 11. glaucoma; 12. V58.9; 13. dementia; 14. 997.5; 15. 707; 16. closed; 17. intellectual disabilities; 18. carcinoma

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