Archive for August, 2011

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.

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 11, 2011

New guidelines are here!

Coding Guidelines were released today, effective Oct. 1, and it does not appear there is anything earth-shattering. With the new glaucoma codes have come a slew of new glaucoma guidelines. Here are some highlights:

Glaucoma additions break out guidelines for glaucoma 365,1-365.7, then breaks the guidelines out by: bilateral glaucoma with same stage, bilateral glaucoma stage with different stages, bilateral glaucoma with different types and different stages, patient admitted with glaucoma and stage evolves during the admission, and undetermined glaucoma stage. (Chapter 6.b)

There is a slight change in the wording of Late effects:
“A late effect is the residual effect (condition produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a late effect code can be used. The residual may be apparent early, such as in cerebrovascular accident cases, or it may occur months or years later, such as that due to a previous injury. Coding of late effects generally requires two codes sequenced in the following order: The condition or nature of the late effect is sequenced first.    The late effect code is sequenced second.

Exceptions to the above guidelines are those instances where the late effect code has been expanded (at the fourth and fifth-digit levels) to include the manifestation(s) or the classification instructs otherwise. The code for the acute phase of an illness or injury that led to the late effect is never used with a code for the late effect.” (Section 1.B.12)

Septic shock (Chapter 1.b.6.a, Chapter 1.b.6.b) include additions for sceptic shock codes:
785.52, Septic shock or 998.02, Postoperative septic shock.

Postprocedural infection and postprocedural septic shock changes address postprocedural infection and complications. Codes involved include: 998.59, 674.3x, 995.92, 998.02. (Chapter 1.10)

Anemia associated with malignancy. There is a clause addition to this area of the guidelines. “If anemia in neoplastic disease and anemia due to antineoplastic chemotherapy are both documented, assign codes for both conditions.” (Chapter 2.c.1)

Complications of care (Chapter 17.f.1) specifies that An additional code identifying the complication should be assigned with codes in categories 996-999, Complications of Surgical and Medical Care NEC, when the additional code provides greater specificity as to the nature of the condition.

August 10, 2011

Hospieces receive payment bump

Hospices serving the Medicare population will see a 2.5 percent increase in their Medicare payments for fiscal year (FY) 2012, according to the Final Rule.

The estimated hospice payments are the net result of a 3.0 percent increase in the “hospital market basket,” an indicator of industry-related price increases, offset by an estimated 0.5 percent decrease in payments to hospices due to updated wage index data and the third year of CMS’ seven-year phase-out of a wage index budget neutrality adjustment factor.

See CMS’s release here