Posts tagged ‘ICD-9 Home Health Coding’

June 26, 2012

Coding education in Texas!

We’re teaching in Texas in July! Come join SHA for coding education in McAllen July 9-10 and Dallas July 30-31.

Beginners: The coding book is friendly if you know how to use it!

  • PLUS: 3.75 nursing contact hours and 3 CEs toward HCS-D maintenance

Intermediate: Go over basic skills, move to PPS, case-mix, RAC targets, and complicated scenarios.

  • PLUS: 9.75 nursing contact hours and 9.75 clock hours for administrators and 10 CEs toward HCS-D maintenance
January 31, 2011

Be aware of glaucoma coding

Today is glaucoma awareness day, so let’s take a quick look at this eye disease.

The basics: Increased introcular pressure causes optic nerve damage and loss of vision, beginning with peripheral vision. Early stages of glaucoma do not have symptoms.

Most glaucomas are in Category 365, except for congenital glaucoma (743.20-743.22) and absolute glaucoma (360.42).

Two years ago, CMS removed the manifestation status of all glaucomas except 365.44, Glaucoma associated with systemic syndromes. This code is used when glaucoma is a manifestation of diabetes, as well as several other diseases.

In these cases, make sure to code the diabetes or other underlying disease first.

For congenital glaucoma, it must be documented by the physician.

January 18, 2011

You cannot keep a patient for PT/INR only

Question: Is it possible to keep a patient for home health only to perform PT/INR labs. Initially we received this patient for CVA. She currently is stable but still requires therapeutic drug monitoring. Every other disease process is stable and been taught on. Is therapeutic drug monitoring a valid reason, and can it be the only reason why we continue to have the patient on board?

Lisa says: Venipuncture is a skill but not a qualifying skill for Medicare home health. A patient such as you described is usually receiving observation and assessment as the skill. Observation and assessment is considered a skill only if there is a potentially fluctuating condition. If there have been no changes, then O and A probably is no longer skilled.

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November 29, 2010

A comorbidity quandry? No, look at treatment and patient health

I continue to receive questions on hypertension (401.9) and pulmonary hypertension (416.0). One reader recently asked if I would consider pulmonary hypertension to be a comorbidity that should always be coded.

Remember that the list of comorbidities “that should always be coded” are examples of diagnoses likely to impact care because of the chronicity. When you code a comorbidity … a condition that affects the patient’s health, or is such an impactful disease that even if it is under control can affect the patient’s health detrimentally and quickly … that you must think about the treatment aspect.

Is pulmonary hypertension under treatment with medications, education, or intervention? Yes, code it. Does pulmonary hypertension have the potential of impacting other conditions? Probably, but remember that CMS requires that comorbidities be addressed in the POC, so what are you doing about the pulmonary hypertension?

Keep in mind that “chronic” does not automatically mean that a disease is a comorbidity. GERD (530.81) is a great example. A patient may have chronic GERD, but if medication has taken care of symptoms for a length of time, what justifies its “status” as a comorbidity? It’s not being treated by home health professionals. There aren’t interventions.

I love this question … someone is thinking on their feet!

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October 3, 2010

New code year … new chance for education!

As we start our new code year, we’re always scrambling for education on codes, but what about other subjects, like PPS fundamentals or OASIS best practices or coding and filling out OASIS information on those pressure ulcers?

It’s time for new education in the new year, and I’m offering these in the month of October, in addition to my live education around the country.

PPS Fundamentals, Monday, October 11
Understand the fundamentals of PPS that are essential to agency operations for administrators, quality personnel and coders. This includes information on:

  • How the HHRG is obtained.
  • Explain the case mix variable table.
  • Identifying how to bill non-routine supplies.
  • Explaining the role of diagnosis coding and OASIS answers to the financial health of a home health agency.

12pm -1:45pm CST

OASIS C Best Practices, Monday, October 18
What is a “best practice”? And what does it mean to your agency? The first quality reports have been released from OASIS C. How did CMS derive the information and how can your agency do better next time? In this education, we will:

  • Define best practice.
  • Discuss best practices involved in pain assessment, falls risk, depression screening and others.
  • Identify the correct method for answering OASIS data items regarding best practices.

12pm -1:45pm CST

Pressure ulcers, coding and OASIS-C, Monday, October 25
Coding pressure ulcers and responding to OASIS data items regarding pressure ulcers are some of the most difficult areas of home health practice. Lisa will lead your staff through the latest guidance on answering OASIS-C regarding pressure ulcers and contrast that with coding guidance. Lisa will:

  • Describe how to answer OASIS and code for pressure ulcers with skin grafts.
  • Describe how to answer OASIS and code for pressure ulcers with muscle flaps.
  • Describe how to answer OASIS and code for pressure ulcers that “heal.”

12pm -1:45pm CST

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