2018 end-of-year Third and Fourth Quarter Coding Clinic review

Why This Topic Matters

It highlights year-end Coding Clinic interpretations and code updates that may affect documentation review, diagnosis sequencing, procedure assignment, and severity-related reporting.

Article Sections

1. Third Quarter 2018

   A review of selected inpatient coding topics addressed in the third quarter guidance. The section covers several procedure- and diagnosis-related questions across multiple body systems.

2. CABG

   Guidance related to coronary artery bypass grafting and related operative documentation issues. The discussion also touches on procedure classification concepts in ICD-10-PCS.

3. Catheter-associated fibrin sheath

   Discussion of coding considerations involving catheter-associated fibrin sheath management. The section addresses how related interventions were reviewed in the quarter’s guidance.

4. Incision and drainage of submandibular space

   Guidance on coding a drainage procedure in the submandibular region. The discussion includes body part selection and documentation of temporary drainage.

5. Decortication of lung

   A coding review involving lung decortication and the associated ICD-10-PCS procedure classification. The section also references documentation clarification when intent is uncertain.

6. Diabetes

   Several diabetes-related questions and related diagnosis-coding considerations. The section addresses diabetic complications, associated vascular disease, and diagnosis sequencing concerns.

7. AMI and chronic total occlusion

   Guidance on diagnosis reporting when acute myocardial infarction is present with chronic coronary occlusion. The discussion references official guideline interaction with Excludes1 notation.

8. Lupus, not otherwise specified

   A clarification issue involving nonspecific lupus documentation. The section addresses the need for provider clarification and possible internal facility guidance.

9. Arteriovenous malformation of the colon

   Coding advice for gastrointestinal bleeding associated with a suspected arteriovenous malformation. The section discusses documentation specificity and acquired-versus-congenital distinctions.

10. GI bleeding from possible multiple sources

    Guidance on reporting suspected sources of gastrointestinal bleeding identified in endoscopic documentation. The section covers how multiple potential sources were addressed in the quarter’s advice.

11. Fourth Quarter 2018

    A review of later-quarter guidance and FY 2019 update topics. The section includes both diagnosis and procedure code changes with potential reporting impact.

12. Code expansion

    Discussion of FY 2019 ICD-10-CM expansion activity. The section summarizes broad categories of updated codes and their impact on reporting and severity indicators.

13. Code creation

    Overview of newly added ICD-10-CM diagnoses in FY 2019. The section provides a high-level look at newly introduced diagnostic categories.

14. ICD-10-PCS changes

    Summary of selected FY 2019 ICD-10-PCS updates. The section covers changes to procedure classification, body systems, device qualifiers, and operating room status.

15. BMI

    Guidance on reporting body mass index and related nutritional or weight status diagnoses. The section addresses documentation significance and reportability considerations.

16. Fine-needle aspiration

    A review of how fine-needle aspiration is addressed in procedural coding. The section focuses on how the procedure is categorized within ICD-10-PCS.

17. CKD related to hypertension and diabetes

    Guidance on chronic kidney disease in the context of hypertension and diabetes. The section discusses assumed relationships and when documentation alters reporting.

18. Summary

    A brief closing recap of the article’s purpose and overall significance. The section does not introduce new coding topics.