Posts tagged ‘home health diagnosis coding’

September 28, 2011

Time for our annual date dance

As codes change Oct. 1, we need to think about which set of codes, 2011 or 2012, we need to use for our patients whose episodes cross over the code change period.

Actually, we need to look at what episodes or assessments cross the code change period. The choice of codes, and CMS confirmed this to me, is based on M0090, the completion of assessment. Soooo…

If the assessment is not complete by Oct. 1, we use 2011 codes for the RAP and EOE. If the assessment is complete by Oct. 1, use the 2012 codes.

What about payment changes over the fiscal year change? CMS has a formula that factors in payment issues. It’s not something for us to worry about.

September 26, 2011

Skin neoplasm codes go the way of 5th digits

All 173 codes are now 5th digits, following the recent trend in neoplasm codes. The bigger issue with these five-digit codes is that CMS has only designated 173.09 as a case-mix code, not the other codes. This takes away our case-mix codes. Almost all neoplasm 173 codes were all case-mix before the 2012 list came out. That should not be done without rulemaking, so there are may queries in to CMS about this issue.

Remember that the codes follow a patter with the 5th digit:

0 = unspecified

9 = other specified (and this is the case-mix code)

Also remember that the codes affected are not melanoma 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.

July 6, 2011

Eye and adnexa, ear and mastoid cover two ICD-10 chapters

Another posting on ICD-10 just to get everyone a little more familiar with the way codes work!

ICD-9 lumps Diseases of the Nervous System and Sense Organs into one chapter, Chapter 6. The specificity of ICD-10, and the fact that ICD-1o groups by anatomy (What a thought! Eye diseases with other eye diseases!) mean big changes to this coding area.

ICD-10 Chapter 7 (H00-H59) deals specifically with Disease of the Eye and Adnexa; Chapter 8 (H60-H95) is devoted to the Diseases of the Ear and Mastoid Process, for example.

The organization, which plays into a logical coder’s mind, means that anatomy knowledge will become more and more important. The eye has several structure and parts from the lens (H25-H28) to conjunctiva (H10-H11) to the cornea (H15-H22, which include other parts, such as the iris) for example.

How about glaucoma? We keep getting new glaucoma codes in ICD-9, partially help map to the codes in ICD-10. Here’s the high-level view of glaucoma coding:

Glaucoma (H40-H42)

H40.  Glaucoma

H40.0 Glaucoma suspect

Ocular hypertension

H40.1 Primary open-angle glaucoma

H40.2 Primary angle-closure glaucoma

H40.3 Glaucoma secondary to eye trauma

H40.4 Glaucoma secondary to eye inflammation

H40.5 Glaucoma secondary to other eye disorders

H40.6 Glaucoma secondary to drugs

H42. Glaucoma in diseases classified elsewhere

McClanahan, Debbie

March 16, 2011

G codes focus on the most important reason for admission

Question: What G-code would be used for initial patient admission into a HHA? Patient is discharged from hospital with CHF exacerbation, new meds. SN does complete assessment, reviews all new and continued medications, medication and disease process teaching, etc., and completes the OASIS, 485, etc.
Lisa says: Assign the G code that reflects what was most important about the visit remembering that the OASIS assessment is not, by itself, billable.