Tag: coding

CMS releases pocket guides for OASIS assessments

Home health agency staff have new tools from CMS to help with OASIS assessments. These pocket guides are expected to assist in assessing and coding self-care and mobility, falls and pressure ulcers/injuries. The pocket guides provide a quick reference for important terms and definitions that promote coding accuracy. They are approximately 2 x 3.5 inches […]

Q&A: ICD-10 Return to Provider codes

Question: “Physical therapy has generalized muscle weakness as a secondary diagnosis, and we are worried this will cause our claim to kick out. Why can’t they just use muscle wasting?” Response: You are correct that generalized muscle weakness would be considered an RTP code for primary diagnosis in I0020B; however, there may be instances during […]

Q&A: Preparing revenue cycle education for clinical staff

Q: What are some key revenue cycle topics that should be included in education geared toward clinical staff? A: Education for clinical staff should be specifically tailored to their functions and their direct interaction with and impact on the revenue cycle. Clinical staff should not be inundated with information that is not relevant to them. […]

New code for capturing vaping-related disorders to be implemented in April

Come April, coders will have a diagnosis code to capture vaping-related disorders. The code, U07.0 (Vaping-related disorder), was established as a new International Classification of Diseases, Tenth Revision (ICD-10) emergency code last year by the World Health Organization (WHO), according to an announcement from the Centers for Disease Control and Prevention (CDC) posted Dec. 9, […]

Quarterly OASIS Q&As offer detail on wound coding

CMS in its latest quarterly OASIS Q&As provided agencies with details about how to code a specific wound scenario. In Question 1 of the April Q&As, one agency asked CMS about a patient admitted with two distinct areas caused by pressure. Notes the agency: “A wound on the left buttock presents with purple localized discolored […]

CMS final rule makes changes to how physicians are paid, delays E/M coding reform

From The Bottom Line. As part of a final rule published by CMS yesterday to reduce provider burnout, the implementation of coding reforms for physician services known as “Evaluation and Management” (E/M) visits–requirements that haven’t been updated in 20 years–were delayed until 2020 to allow for continued stakeholder engagement. For CY 2019 and CY 2020, […]

Breaking News: CDC releases final list of 2019 ICD-10-CM codes

Brought to you by Home Health Line. Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention. The majority of the new codes added […]

Home health: Surgical wound infection codes set to expand dramatically in FY2019

Provided by Home Health Line. Home health coders could have 435 ICD-10-CM code changes to deal with starting Oct. 1, with 247 new codes, 139 revised codes and 49 codes rendered invalid, according to the proposed hospital inpatient prospective payment system rule (IPPS) rule released April 24. One notable code, T81.4xxA (Infection following a procedure, […]

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017. The advance notice of proposed rulemaking, titled “Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology,” was published […]

CMS orders post-pay audit of SNF PPS claims

The Supplemental Medical Review Contractor (SMRC) is charged with conducting nationwide medical review as directed by the Centers for Medicare & Medicaid Services (CMS). Topics and timeframes for these reviews are dictated by CMS and are chosen to address specific agency interests regarding coverage, coding, payment, and billing practices. On March 17, 2017, SMRC announced […]