Posts tagged ‘selmanholmanblog’

December 7, 2010

Coding education in Vegas does not stay in Vegas!

Go back to your agency as a coder or administrator and share the information you learned at the Coding and Regulatory Symposium! Come to my two-day class focusing on recent coding changes, especially those impacting wounds and therapy, with a focus on regulations and how these changes impact the bottom-line of agencies.

January 27-28, 2011, Monte Carlo Resort and Casino in Las Vegas, Nevada
9:00AM -4:15PM each day

This class is appropriate for all levels of coders, plus administrators who want to learn more about how coding impacts revenues and operations.

Agenda Day 1

Morning focus: Regulatory Issues
9:00‐10:00  How Coding and OASIS Add to Your Case Mix Score
10:00‐10:45  Myths and Truths that Impact Therapy Coding
10:45‐11:00 Break
11:00‐11:30 Common Errors Impacting Your Payment and Outcomes
11:30‐12:00 ICD‐10 and the 2011 Change to the 5010 Format
12:00‐1:00 Lunch
Afternoon focus: Applying regulatory education to coding
1:00‐2:00  Sequencing and Coding Guidelines
2:00‐2:45  Interactive Coding Session
2:45‐3:00 Break
3:00‐4:15 Interactive Coding Session (continued)
4:15  Adjournment
Agenda Day 2
9:00‐10:30 Wound Care Coding: All Wrapped Up
10:30‐10:45 Break
10:45‐12:00 Interactive Coding Session
12:00‐1:00 Lunch
1:00‐2:30 How Jan. 1 PPS Changes Impact your Operations
2:30‐2:45 Break
2:45‐3:30 How to Support Your Coding and Appeal Downcoding
3:30‐4:15 Facts and Forward Thinking about ICD‐10‐CM and ICD‐10‐PCS
4:15 Adjournment

Coming to Vegas?

$49 a night! That’s the price we have arranged (plus $12.95 for a resort fee) for each night at the Monte Carlo!!

Looking for a registration form?

October 16, 2010

You can code HTN primary, even with medical edits

Many times, I advise against listing a chronic condition as primary unless there is an exacerbation or strong ability to show why it is the leading reason for home care. There are also multiple medical edits that flag certain diagnoses as primary after multiple episodes.

Can you safely code HTN or CHF or another chronic disease primary after multiple episodes? Yes, of course, if your documentation can support your choice.

Let’s say you have a patient with severe HTN. Her primary physician made conservative changes during the first two certification periods, and those changes did not get the HTN under control. She started seeing a cardiologist, who made several medication changes, and the HTN is finally starting to be controlled. Because her blood pressure isn’t entirely stable, she still requires teaching and monitoring.

She has a couple of chronic conditions that are controlled, but none of them involve teaching and monitoring. Medical edits such as these don’t just review the code choice. Medical reviewers are looking for skilled care, e.g. does the condition have the potential for fluctuation and thus qualify for skilled observation and assessment?

In the scenario above, you absolutely put HTN first; you are using your nursing skills to teach and monitor. Your coding may still get caught in an edit, but your documentation will prevail.

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