2020 Official ICD-10-CM Coding Guideline Changes Are Here!
By Wyn Staheli, Director of Research | Published October 1st, 2019
It’s that time of year for offices to get ready for the ICD-10-CM code revisions. As part of that process, it’s also good to know what is going on with the ICD-10-CM Official Guidelines for Coding and Reporting. In the examples listed below, strikeout text is deleted and highlighted text ...
Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 1st, 2019
Atrial fibrillation (AF) is the most common type of abnormal heart rhythm (arrhythmia). It is caused by a disorder in the heart’s electrical system. AF is the result of abnormal contractions of the atria (upper two chambers of the heart) causing them to quiver and beat out of sync with ...
The New ICD-10-CM Code Updates Are Here — Are You Ready?
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 1st, 2019
Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)
A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases.
Chapter 2: ...
Vaccine Administration - When The Right Vaccine Code is Not Enough
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 30th, 2019
Understanding how to apply immunization administration codes properly will support correct reimbursement for vaccinations. Reporting the right vaccine code alone is not enough to guarantee proper billing. The majority of the time, providers can charge for the vaccine/product as well as the administration of the vaccine; always consult your payer ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 13th, 2019
There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ...
Q/A: Do I Use 7th Character A for all Sprain/Strain Care Until MMI?
By Wyn Staheli, Director of Research | Published July 15th, 2019
Question:
It is in regards to the Initial and Subsequent 7th digit (A and D) for sprains and strains. Recently, I have been told that I should continue with the A digit until the patient has reached Maximum Medical Improvement (MMI) and then switch over to the D place holder. Is ...
By Marge McQuade, CMSCS, CHCI, CPOM | Published July 9th, 2019
ICD-10-CM codes represent the first line of defense when it comes to medical necessity. Correctly chosen diagnosis codes support the reason for the visit as well as the level of the E/M services provided. The issue of medical necessity is one of definitions and communication. What is obvious to the ...
How to Properly Report Monitoring Patients Taking Blood-thinning Medications
By Wyn Staheli, Director of Research | Published June 18th, 2019 - Last Review/Update June 19th, 2019
Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services.
By Namas | Published May 31st, 2019 - Last Review/Update June 4th, 2019
Auditing Hospitalist Services
The inpatient side of coding and auditing can be enormously complex, with many more moving parts than are typically found in the outpatient setting. In this audit tip, we will discuss a few of the challenges that come with auditing one of the most important players in the ...
What is Medical Necessity and How Does Documentation Support It?
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published April 23rd, 2019
We recently fielded the question, “What is medical necessity and how do I know if it's been met?"
The AMA defines medical necessity as:
It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...
By By Evan M. Gwilliam, DC MBA BS CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow Clinical Director, PayDC Chiropractic EHR Software President, Gwilliam Consulting LLC drgwil@gmail.com | Published April 22nd, 2019
Chiropractic is unique from other types of health care and auditors need to be aware of the nuances of this field. Chiropractic has become the focus of more and more audits as doctors seem to struggle to create records that properly support the care provided to the patient throughout the entire episode.
By Wyn Staheli, Director of Content | Published April 22nd, 2019
Question: I got a denial on my claim and it said the problem was with the diagnoses codes that I used. I used M54.15 and M79.2. I don’t understand why this is a problem.
By Wyn Staheli, Director of Research | Published April 15th, 2019
Question: My patient has a lot of chronic conditions. Do I need to include all these on the claim? I know that I can have up to 12 diagnoses codes on a single claim. What if I need more than that?
Answer: More is not always better. You only need to ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published April 1st, 2019
Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes.
ICD-10-CM Diagnosis Codes ...
By Wyn Staheli, Director of Research | Published April 1st, 2019 - Last Review/Update April 2nd, 2019
One constant in our industry is change. Policies change, contracts change, and there are updates. Also, people aren’t perfect and mistakes can be made. So this article will cover a variety of topics.
Published Articles
We appreciate feedback from our valued customers. We have received feedback regarding two of our articles which ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 27th, 2019
When coding with ICD-10-CM, pain codes can be found in different sections:
The Body System affected or site-specific pain codes, such as Low Back Pain M54.5, can be found in Chapter 13. Diseases of the Musculoskeletal system (M00-M99). Other examples might be ocular pain H57.1, found in Chapter 7. Diseases of ...
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published March 18th, 2019
If you've ever taken piano lessons, you know that the thumb is considered the first finger of the hand. Anatomically, it is also referred to as the first phalanx (finger). However, when you are coding an x-ray of the thumb, images are captured of the thumb, hand, wrist, and all ...
By Wyn Staheli, Director of Research | Published March 4th, 2019 - Last Review/Update March 6th, 2019
Code 95992 has some very limited payer payment guidelines which need to be understood for proper reimbursement. Many payer policies consider this service bundled with Evaluation and Management Services, therefore, it would not be separately payable if there was an E/M service performed on the same date. Some providers have reported having trouble ...
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published February 12th, 2019
The Medicare Initial Preventive Physical Exam (IPPE), also commonly referred to as the “Welcome to Medicare Physical”, may seem daunting to many, but when broken out to identify the requirements is fairly straightforward.
Purpose
An IPPE helps the Medicare beneficiary (the patient) get to know their healthcare provider at a time when they ...
Truncated ICD-10-CM Official Guidelines for Coding and Reporting
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 22nd, 2019
Adherence to ICD-10-CM official guideline's are required under HIPAA and adopted for all healthcare settings. We have made it easy to access guidelines and made them available on the code information page, either on the page you are viewing or view more information by selecting the ICD-10-CM Chapter Section/Guidelines and ...
By Wyn Staheli, Director of Research | Published January 3rd, 2019
The new year is upon us and so it’s time to double check and make sure we are ready. Those with Premium Membership can use the ChiroCode Online Library and search all the official code sets: ICD-10-CM, CPT, and HCPCS. It also includes the updated NCCI edits and RVUs for ...
By BC Advantage | Published November 26th, 2018 - Last Review/Update November 29th, 2018
This article will focus on the Present on Admission (POA) indicator which is used as a method of reporting whether a patient’s diagnoses are present at the time they are admitted to a facility. We’ll look at a few scenarios to determine the correct reporting of POA and the impact...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published November 8th, 2018
Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections:
Acute rheumatic fever (I00-I02)Chronic rheumatic heart diseases (I05-I09)Hypertensive diseases (I10-I16)Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)Other forms of heart disease (I30-I52)Cerebrovascular diseases (I60-I69)Diseases of arteries, ...
Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder
By Wyn Staheli, Director of Research | Published October 19th, 2018 - Last Review/Update December 19th, 2018
The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association's Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and ...
By Wyn Staheli, Director of Research | Published October 16th, 2018
Pelvic floor dysfunction is often the underlying cause of conditions such as pelvic pain; urinary or bowel dysfunction; and/or sexual symptoms. Treatment generally begins with an evaluation and testing (e.g, EMG) followed by a variety of services (e.g., biofeedback, manipulation, pelvic floor electrical stimulation), depending on the findings.
Coverage by payers ...
Q/A: What Diagnosis Codes Should I Use for TMJ Headache Massage for Coverage?
By Wyn Staheli, Director of Research | Published October 16th, 2018
Question:
We have been receiving several DDS referrals to our massage therapists who do intra-oral work. The only problem is that the referral from the DDS lists code R51 for headaches as the only DX code. Since most plans don't cover massage therapy for headaches alone, are there any codes that can distinguish the headaches as ...
By Christine Woolstenhulme, QMC, QCC, CMCS, CPC, CMRS | Published October 2nd, 2018
Life Care Planners play a vital and underappreciated including understanding the progression of a disease and lifetime clinical treatment options, research, delete (I combined this into the paragraph above) compiled into one easy-to-use resource. a unified providing a single destination for procedure coding coding to find information on...
The Potential Impacts of a Flat Rate EM Reimbursement on our Industry
By BC Advantage | Published September 26th, 2018 - Last Review/Update October 17th, 2018
The proposed E&M changes by CMS would decrease provider administrative work burden by, per CMS, 51 hours a year; however, how will reducing documentation requirements truly affect the professionals of the healthcare industry? First, let’s discuss the 30,000-foot overview of the most impactful E&M changes—which is the change to the...
2019 Code Changes are Just Around the Corner - Are You Ready?
By Wyn Staheli, Director of Research | Published September 24th, 2018 - Last Review/Update January 28th, 2019
The leaves are beginning to change and it’s time once again for the annual code changes for 2019. ICD-10-CM codes are out and will be effective October 1, 2018. CPT code changes also just came out and will be effective January 1, 2019. The ChiroCode DeskBook and ICD-10-CM Coding for Chiropractic books have been ...
By Chris Woolstenhulme QCC, CMCS, CPC, CMRS | Published August 15th, 2018 - Last Review/Update August 17th, 2018
Date: October 9-10 Time: 9-3 MST
QPro Con is featuring a virtual event with keynote speakers and experts with years of hands-on experience in the healthcare industry. Stay ahead of the changes and keep informed of important information that affects the healthcare community.
Attendees receive 12 FREE CEUs with the purchase ...
Why Is Medicare Denying My Claims for Mammography and Breast Biopsies?
By BC Advantage | Published June 4th, 2018
When Medicare updated their systems with the updates to mammography and breast biopsy policies some ICD-10-CM codes were inadvertently left out. The omitted new codes are N63.11-N63.14, N63.21-N63.24, N63.31, N63.32, N63.41, and N63.42, which will replace the truncated ICD-10 diagnosis N63. The Centers for Medicare & Medicaid Services (CMS) will...
By BC Advantage | Published May 30th, 2018 - Last Review/Update June 4th, 2018
According to the National Institutes of Health, a review was carried out on 20 patients who had a pectoralis major muscle repair between 2003 and 2011, and the results were as follows....
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Annual Wellness Visit
Procedure Codes G0438: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0439: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 99385: Initial comprehensive preventive medicine evaluation and management of an individual including ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Bone Mass Measurements
Procedure Codes G0130: Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) 76977: Ultrasound bone density measurement and interpretation, peripheral site(s), any method 77078: Computed tomography, bone mineral density study, 1 or more ...
Preventive Medicine: Breast Cancer Genetic Screening
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Breast Cancer Genetic Screening
Procedure Codes 81211: BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Cardiovascular Disease Screening Tests
Procedure Codes 80061: Lipid panel. This panel must include the following:
Cholesterol, serum, total
Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol)
Triglycerides
82465: Cholesterol, serum, total 83718: Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) 84478: Triglycerides 83721: Lipoprotein, direct measurement; LDL cholesterol 83719: Lipoprotein, ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Colorectal Cancer Screening
Procedure Codes G0104: Colorectal cancer screening; flexible sigmoidoscopy G0105: Colorectal cancer screening; colonoscopy on individual at high risk G0106: Colorectal cancer screening; screening sigmoidoscopy, barium enema G0121: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0122: Colorectal cancer screening; barium ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Therapy for Fall Prevention
Procedure Codes 97110: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility 97112: Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Glaucoma Screening
Procedure Codes G0117: Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist G0118: Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
ICD-10-CM G0117-G0118: Z13.5
Frequency G0117-G0118: Once a year
Additional information G0117-G0118
Coverage as is indicated with ...
Preventive Medicine: Hepatitis B Virus (HBV) Vaccine and Administration
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Hepatitis B Virus (HBV) Vaccine and Administration
Procedure Codes G0010: Administration of hepatitis b vaccine 90739: Hepatitis B vaccine (HepB), adult dosage, 2 dose schedule, for intramuscular use 90740: Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use 90743: Hepatitis ...
Preventive Medicine: Hepatitis C Virus (HCV) Screening
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Hepatitis C Virus (HCV) Screening
Procedure Codes G0472: Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 87522: Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed 86804: Hepatitis C antibody; confirmatory test (eg, ...
Preventive Medicine: Influenza Virus Vaccine and Administration
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Influenza Virus Vaccine and Administration
Procedure Codes Q2034: Influenza virus vaccine, split virus, for intramuscular use (agriflu) Q2035: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) Q2036: Influenza virus vaccine, split virus, when administered to individuals ...
Preventive Medicine: Medical Nutrition Therapy and Cardiovascular Disease (CVD)/Obesity Prevention
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Medical Nutrition Therapy and Cardiovascular Disease (CVD)/Obesity Prevention
Procedure Codes G0270: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Lung Cancer Screening
Procedure Codes G0296: Counseling visit to discuss need for lung cancer screening (ldct) using low dose ct scan (service is for eligibility determination and shared decision making) G0297: Low dose ct scan (ldct) for lung cancer screening S8092: Electron beam computed tomography (also ...
Preventive Medicine: Pneumococcal Vaccine and Administration
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Pneumococcal Vaccine and Administration
Procedure Codes G0009: Administration of pneumococcal vaccine 90670: Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use 90732: Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
ICD-10-CM G0009, ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Prostate Cancer Screening
Procedure Codes G0102: Prostate cancer screening; digital rectal examination G0103: Prostate cancer screening; prostate specific antigen test (PSA)
ICD-10-CM G0102-G0103: Z12.5
Frequency G0102-G0103: Once annually
Additional Information G0102-G0103
Only for males aged 50 and older
G0102
Copayment and deductible may apply, consult your payer
Find-A-Code™ - Preventive Services - ...
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Screening Mammography
Procedure Codes 77052: Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; screening mammography (list separately in addition to code for primary procedure) 77057: Screening mammography, bilateral ...
Preventive Medicine: Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)
Procedure Codes 76706: Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) 76770: Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76775: Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real ...
Preventive Medicine: Screening Children for Visual Acuity
By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update August 1st, 2018
Preventive Medicine Topics Page
Screening Children for Visual Acuity
Procedure Codes 99173: Screening test of visual acuity, quantitative, bilateral
ICD-10-CM 99173: Z00.121, Z00.129, Z00.100, Z00.101
Frequency 99173: No specific frequency guidelines
Additional Information 99173
Not covered by Medicare for preventative care
Some policies will only cover as preventive for children, consult your payer
Find-A-Code™ - Preventive ...
By Find-A-Code | Published May 9th, 2018 - Last Review/Update August 2nd, 2018
Preventive Medicine Topics Page
Dental Caries in Children
Procedure Codes 99188: Application of topical fluoride varnish by a physician or other qualified health care professional
ICD-10-CM 99188: No specific diagnoses
Frequency 99188: No specific frequency guidelines
Additional Information 99188
Covered for children from birth until their seventh birthday
Find-A-Code™ - Preventive Services - The information ...
Q/A: I am Having Trouble with a Claim Rejection on my PI Claim. What do I do?
By Wyn Staheli, Director of Research | Published April 12th, 2018 - Last Review/Update February 4th, 2019
Question:
I have a patient that was involved in a PI case. His lawyers are asking that we bill his insurance company first. This particular patient has xxxx insurance and the clearing house is rejecting the claim based on "ERROR 3430-Invalid principal diagnosis code." We lead with diagnosis code V43.52XA, could we change the position of the V43.52XA code? Or should we submit a paper claim for the case instead?
By BC Advantage | Published March 27th, 2018 - Last Review/Update April 12th, 2018
From internal reviews to external inpatient coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind....
By Wyn Staheli, Director of Research | Published March 13th, 2018 - Last Review/Update January 31st, 2019
Question: I have a provider that provides Department of Transportation (DOT) exams. I have found ICD-10 code Z02.4 (encounter for examination for drivers license) but I am unsure which CPT Code to use. Would I still use 99203 or 99204?
Z Codes That May Only be Principal/First-Listed Diagnosis
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 28th, 2018
Z Codes That May Only be Principal/First-Listed Diagnosis
According to 2018 Guidelines section: 1;C.21.c.16, the following Z codes/categories may only be reported as the principal/first-listed diagnosis, except when there are multiple encounters on the same day and the medical records for the encounters are combined:
Z00 Encounter for general examination without ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 1st, 2018
It is important to make a clear distinction between pre-existing conditions and conditions brought on by the pregnancy (gestational) or pregnancy related conditions.
Condition Detail: Was the condition pre-existing (i.e., present before pregnancy)?
Trimester: When did the pregnancy-related condition develop?
Casual Relationship: Establish the relationship between the pregnancy and the complication (e.g., preeclampsia)
Code examples:
O99.011 Anemia ...
Patients Undergoing a Bone Marrow Transplant (BMT)
By Find-A-Code | Published February 1st, 2018
Accoring to Wisconsin Physicians Service Insurance Corporation L34699, when using J2820 for patients undergoing a bone marrow transplant (BMT), 2 diagnosis codes are required:1) Z76.82 Awaiting organ transplant status2) Pick a code from one of these categories:
C81- Hodgkin Lymphoma
C82- Follicular Lymphoma
Non-follicular Lymphoma
C83.1- Mantle cell lymphoma
C83.3- Diffuse large B-cell lymphoma
C83.7- Burkitt lymphoma
C83.8- Other (Intravascular large B-cell lymphoma, Primary effusion B-cell lymphoma, or Lymphoid granulomatosis)
Mature T/NK-cell lymphomas
C84.4- Peripheral T-cell ...
Diagnosis Codes Used With : Vertebroplasty, Vertebral Augmentation and Computed Tomography
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 1st, 2018
Per CGS Administrators LCD L34048 the following codes are the ICD-10-CM Cdes that support Medical Necessity: (Be sure to verify with your local payer)
Stand Alone ICD-10 codes
M80.08XA
M80.88XA
M80.88XG
Primary Diagnosis Codes
M48.51XA
M48.52XA
M48.53XA
M48.54XA
M48.55XA
M48.56XA
M48.57XA
M48.58XA
M84.68XA
Secondary Diagnosis Codes
One of the following diagnosis codes must be reported with one of the codes above in group 2.Combination coding of the primary diagnosis(group 2) of pathologic fracture ...
By Natalie Tornese, CPC | Published February 1st, 2018
The following information is from BC Advantage.
Colonoscopy is a common procedure performed byGastroenterologists. CPT defines a colonoscopy examination as "the examination of the entire colon, from the rectum to the cecum or colon-small intestine anastomosis, and may include examination of the terminal ileum or small intestine proximal to an anastomosis" ...
Q and A: Coding Mixed Cardiogenic and Septic Shock
By BC Advantage | Published February 1st, 2018
Q: If the attending documented, "likely mixed cardiogenic and septic shock," can I assign codes R57.0 and R65.21? A: Refer to the documentation within the code book. If you open the book to the R57 code grouping (Shock not elsewhere classified) listed below there is an Excludes1 note. Remember,...
By Richard Pinson, MD, FACP, CCS, and Cynthia Tang, RHIA, CCS | Published February 1st, 2018
COPD and Pneumonia The requirement for code J44.0 (chronic obstructive pulmonary disease with acute lower respiratory infection) to be coded first when a patient has pneumonia and COPD has been eliminated as of October 1. The 2018 version of ICD-10-CM replaced the "use additional code" with "code also." According...
By Wyn Staheli, Director of Research | Published February 1st, 2018
There has been some controversy over the use of the ICD-10-CM subluxation codes commonly referred to as traumatic (S13.1-, S23.1-, and S33.1-). Are they appropriate for chiropractors to use? The answer to that question is complicated. The problem basically lies in the lack of official guidance and differing opinions on ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 31st, 2018
With this year's Flu season being the most widespread on record, providers are seeing more patients and giving more immunizations for influenza than normal. Here are a few things to keep in mind during this flu season.
Know the rules with your payers to ensure proper reimbursement and correct billing. For example, did you ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 29th, 2018
The following codes are the most common Pain codes used in ICD-10
G89.0 Central pain syndrome Chronic Condition
G89.11‑G89.18 G89.1 Acute pain, not elsewhere classified
G89.21‑G89.29 G89.2 Chronic pain, not elsewhere classified
G89.3 Neoplasm related pain (acute) (chronic) Chronic Condition
G89.4 Chronic pain syndrome
There are more specific pain ...
Aftercare visit codes cover situations when the initial treatment of a disease has been performed, and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. The aftercare Z code should not be used if treatment is directed at a current, ...
There are three observation Z code categories. They are for use in very limited circumstances when a person is being observed for a suspected condition that is ruled out. The observation codes are not for use if an injury or illness or any signs or symptoms related to the suspected ...
The following information is according to Novitas Solutions L35084.
Mesenteric vessels: This includes
Acute mesenteric ischemia
Chronic mesenteric ischemia
Mesenteric thrombosis
Dissection or any other vascular insufficiency resulting in gastrointestinal symptoms
Stenting of the mesenteric vessels is covered only when angioplasty of the vessels would not suffice and after the patient has had a thorough medical evaluation and management of symptoms, and for whom surgical intervention is the likely ...
NEW on Find-A-Code...National Coverage Determinations (NCDs)
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 23rd, 2018 - Last Review/Update January 25th, 2018
Medicare limits its coverage of services to those considered to be reasonable and necessary for the diagnosis and treatment of an injury or illness based on coverage guidelines. National Coverage Determinations (NCDs) are created based on research, evidence-based processes, public participation, and other resources, and made available to the public. ...
The following information is according to Novitas Solutions L35084.
Lower extremity arteries (abdominal aorta, iliac, superficial femoral and infrapopliteal arteries): This includes:
Lifestyle-limiting claudication
Focal hemodynamically significant lesion
Ischemic rest pain
Non-healing tissue ulceration
Focal gangrene
Stent placement in infrapopliteal vessels is not expected to be often indicated and in those cases the rationale for stent placement must be explained in the record.
CPT codes:
37221
37223
37226
37227
37230
37231
37234
37235
ICD-10-CM codes:
Type 1 diabetes mellitus
E10.51 - with diabetic peripheral angiopathy without gangrene
E10.59 - with other circulatory ...
The following information is according to Novitas Solutions L35084.
Renal artery: Stenting may be indicated for renal artery stenosis causing renovascular hypertension (see below) or renal insufficiency as well as post-transplant renal artery stenosis, arterial aneurysm or dissection. Renal artery angioplasty with or without stenting is covered for renal artery stenosis manifested by at least one of the following conditions:
Recurrent (“flash”) pulmonary edema without cardiac ...
According to Novitas Solutions L35084
Brachiocephalic arteries (including subclavian, except carotid bifurcation): Stenting may be indicated for treatment of flow-limiting stenosis resulting in conditions such as:
Subclavian steal syndrome
Upper extremity claudication
Ischemic rest pain of the arm and hand
Non-healing tissue ulceration
Focal gangrene.
CPT codes:
37236
37237
ICD-10-CM codes:
G45.8 - Other transient cerebral ischemic attacks and related syndromes
Unspecified atherosclerosis of native arteries of extremities
I70.201 - right leg
I70.202 - left leg
I70.203 - ...
Osteonecrosis is a serious bone disease caused when the bone is starved of its normal blood supply. Because bone is living tissue, without a good supply of oxygenated blood, it becomes weakened and then dies. Scientists have not been able to identify the exact cause of osteonecrosis of the jaws, but they have ...
The following information is from LCD L36276.
The diagnosis codes listed below require the use of the EC modifier (ESA administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy) when submitting claims for J0888. In addition, these diagnosis codes are marked with an * indicating they require a dual diagnosis. The ...
Non-Coronary Vascular Stents: Inferior vena cava and iliofemoral veins
By Find-A-Code | Published January 9th, 2018
The following information is according to Novitas Solutions, L35084.
Inferior vena cava and iliofemoral veins: This includes vena cava and iliofemoral venous occlusions and stenosis due to the following
Post-radiation venous stenosis
Congenital stenoses or webs
Extrinsic venous compression (May-Thurner syndrome)
Thrombophlebitis and symptomatic post-traumatic venous stenosis.
CPT codes:
37238
37239
ICD-10-CM codes:
Phlebitis and thrombophlebitis
I80.10 - of unspecified femoral vein
I80.11 - of right femoral vein
I80.12 - of left femoral vein
I80.13 - of femoral vein, bilateral
I80.211 - of right iliac vein
I80.212 - of left iliac vein
I80.213 - of iliac vein, bilateral
I80.219 - of unspecified iliac vein
I80.8 - of ...
By Christine Woolstenhulme | Published January 9th, 2018
This code is commonly used to bill for AcuKnee products. Per AcuKnee, “NMES and electrotherapy may be covered by most insurance providers, provided the following criteria are met;”
Documentation of chronic pain or muscle atrophy 3 months or longer
Must document improvement
Must have physician document medical necessity/Prescription
Appropriate authorization from your insurance provider
Suggested codes when billing
64550 initial electrotherapy education and placement
E0720 Electrotherapy unit itself
E0731 Garment ...
When coding for preventive care, be sure to use the correct encounter code with the procedure as well as the appropriate modifier if required.
New Patient: A patient that has not received any professional services i.e., E&M or any other face to face service from the physician or group within the ...
By Marge McQuade, CMSCS, CHCI, CPOM | Published January 4th, 2018
Adequate documentation is an essential part of selecting a correct code in any setting. When providers order a test, the information that they document regarding the test results determines the primary and secondary diagnosis codes a coder assigns.
If a physician confirms a diagnosis based on the results of a diagnostic ...
According to the official ICD-10-CM Guidelines, in situations of maltreatment (e.g., adult and child abuse, neglect, etc.), the sequence of coding is important. Regardless of whether it is suspected or confirmed, it is important to document the type of abuse. Use the following sequence:
An appropriate code from category T74- (confirmed) or T76- (suspected)
Any accompanying mental ...
Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 3rd, 2018
There is important information that must be included when documenting injuries and external cause codes in ICD-10-CM. There are expanded sections on poisonings and toxins making it more convenient to code, as ICD-10-CM is very specific.
When using a code from Chapter 19. Injury, Poisoning and Certain other Consequences of External ...
Orthognathic surgery is corrective jaw surgery, which payers classify as either medically necessary or aesthetic (not medically necessary). With most payers, surgery performed to correct functional impairments, after conservative measures have failed, would be considered medically necessary.
Conditions considered medically necessary for this surgery may include:
Skeletal deformities of the maxilla or mandible causing ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published December 12th, 2017
The exact level of the subluxation must be specified in the documentation to substantiate payment of a claim.
You may document the exact bones such as C3, C3 or the area if it implies only certain bones such as the Occipito-atlantal - Occiput, and C1 (Atlas).
C1 is the first vertebra known as the atlas. The axis-form is ...
By Wyn Staheli, Director of Research | Published November 30th, 2017 - Last Review/Update February 5th, 2019
Q: In order to code carpal tunnel syndrome G56.01 or G56.02, does there need to be documentation that nerve conduction (EMG testing) has been performed to confirm the diagnosis?
By Wyn Staheli, Director of Research | Published November 27th, 2017
Coverage
ESA is typically covered for the following condition(s):
Treatment of anemia associated with chronic renal failure (whether or not that patient is on dialysis)
Treatment of significant anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitantly administered chemotherapy
Treatment of anemia due to AZT and/or other Nucleoside Reverse Transcriptase Inhibitors (NRTI) used in treatment of HIV/AIDS
Treatment of selected ...
Q/A: Physical Exam for Military (Specifically Feet)
By Codepedia | Published November 8th, 2017 - Last Review/Update November 21st, 2017
Q: We had a patient come to our podiatry clinic to get a physical for her feet to qualify for ROTC activities. They came back clear of any deformities, defects, etc. Our scribes listed this visit diagnosis as Z00.00 (Encounter for general adult medical examination without abnormal findings) which seems correct ...
By Shannon Cameron, MBA, MHIIM, CPC | Published September 29th, 2017 - Last Review/Update January 31st, 2018
Big data and its use in the healthcare spectrum has proven to be an incredible source of the knowledge and has rapidly abetted progress in seemingly all areas of healthcare......
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 20th, 2017
CMS recently released a new LCD for Jurisdiction F, Bladder/Urothelial Tumor Markers (L36680).
Documentation Requirements
The medical record must clearly identify the number and frequency of bladder marker testing. Medical record documentation must be legible, must be maintained in the patient’s medical record (hard copy or electronic copy), and must meet the ...
ICD-10-CM Coding Advice for Healthcare Encounters in Hurricane Aftermath
By BC Advantage | Published September 12th, 2017 - Last Review/Update January 25th, 2018
This document is intended to be used as a guide to help coding professionals when coding healthcare encounters of those individuals affected by a hurricane.
By Christine Taxin | Published September 11th, 2017
What has been your definition so far when asked about how they are different? What does an ICD-10 code look like? How does an ICD-10 code work?
Have you seen commercials about medical coding schools and wonder if the profession is right for you? With the field expected to grow faster ...
By Wyn Staheli, Director of Research | Published September 1st, 2017 - Last Review/Update October 16th, 2017
NOTICE: This table was created for use by those who have purchased a Find-A-Code specialty specific Reimbursement Guide. Please do not share with others.
Codes in bold are complete codes of the highest specificity.
Codes with ** are listed in the DSM-5 which contains diagnostic criteria.
The underscore ( _ ) means that an ...
By Find-A-Code | Published September 1st, 2017 - Last Review/Update February 2nd, 2018
The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Cardiovascular Disease Screening Tests:
80061 -
Lipid panel, this panel must include the following:
82465 - Cholesterol, serum, total
83718 - Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol)
84478 - Triglycerides
Z13.6
All Medicare beneficiaries without apparent signs or symptoms ...
Preventive Services: Lung Cancer Counseling and Annual Screening for Lung Cancer With LDCT
By Find-A-Code | Published September 1st, 2017 - Last Review/Update January 31st, 2018
The following information from the Medicare Learning Network provides guidance on Lung Cancer Screening Counseling, and Annual Screening for Lung Cancer With Low Dose Computed Tomography (LDCT)....
Preventive Services: Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests
By Find-A-Code | Published September 1st, 2017 - Last Review/Update January 31st, 2018
The following information from the Medicare Learning Network provides guidance on Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests....
Preventive Services: Screening for STIs and High Intensity Behavioral Counseling (HIBC) to Prevent STIs
By Find-A-Code | Published September 1st, 2017 - Last Review/Update January 31st, 2018
The following information from the Medicare Learning Network provides guidance on Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs.....
By Find-A-Code | Published September 1st, 2017 - Last Review/Update January 31st, 2018
The following information from the Medicare Learning Network provides guidance on Screening Pelvic Examinations (includes a clinical breast examination)....
Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 11th, 2017
There is important information that must be included when documenting injuries and external cause codes in ICD-10-CM. There are expanded sections on poisonings and toxins making it more convenient to code, as ICD-10-CM is very specific.
When using a code from Chapter 19 (Injury, Poisoning and Certain other Consequences of External ...
Occasionally, when a customer searches for a code with key words with the comprehensive search, we get feedback that they are not getting the correct results. Some of the main reasons are the correct code set is not selected in the search box.
Other times customers are not searching the keywords and notes. ...
36522 Photopheresis Extracorporeal; Not Payable Without Certain ICD-10-CM Codes
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published July 28th, 2017
When Outpatient hospitals bill CPT code 36522: (Photopheresis, extracorporeal), it must be billed with the following diagnosis codes:
C84.00 - C84.09 Mycosis fungoides;
C84.10 – C84.19 Sezary’s disease;
T86.20 – T86.298 Complications of heart transplant;
T86.30 – T86.39 Complications of heart-lung transplant;
T86.00 - T86.09 Complications of transplanted bone marrow.
Review your local LCD for billing and coding help.
...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published July 27th, 2017
There is still confusion on the use of the seventh character. Let's clarify a few common areas.
The 7th character represents the physicians encounter, but not the number of visits.
Reporting the phase of treatment the patient is seeing the provider for, but not the number of injuries or number of visits.
The most common ...
Diagnosing, Documenting, and Coding for Radiculopathy
By Evan Gwilliam, DC, MBA, BS, CPC, CCPC, CPC-I, CPMA, NCICS, MCS-P, QCC, CMHP | Published June 30th, 2017
Radiculopathy can be an unpleasant condition, but diagnosing, documenting and coding for it does not have to be. It just takes a little research. The brain communicates with the body via the spinal cord which is protected by the bones of the spinal column, called vertebrae. Nerve roots exit in ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published June 29th, 2017
The new proposed 2018 ICD-10-CM codes have been announced and are to be used for discharges occurring from October 1st, 2017 through September 30th, 2018 and for patient encounters occurring from October 1st, 2017 through September 30th, 2018.
The 2018 General Equivalence Mappings (GEMs) will be available in August 2017. The ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published June 28th, 2017 - Last Review/Update July 26th, 2017
Using the X Place holder is not optional. Be sure you understand how to use it. If the code you are using requires a the Character such as the A - initial encounter, D - subsequent encounter or S- sequela, you understand the "X" Place holder. Not all Codes requiring a 7th ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 25th, 2017
Risk Adjustments are used to access an illness or severity and comparing classifications of diseases using diagnosis codes.
Find-A-Code gives you the ability to search for risk codes used for calculations on an individual code or calculator for a group of codes to quickly calculate a risk score.
Keep in mind prior ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 5th, 2017 - Last Review/Update July 26th, 2017
The ICD-10-CM Guidelines will direct you when coding as to which diagnosis should be first listed and what should not be listed first. Pay careful attention to ensure correct coding and avoid claim denial. There are a few basic rules you should be familiar with as well as common issues when ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published April 20th, 2017 - Last Review/Update July 28th, 2017
When billing dermal filler injections, separate payment may be made under the OPPS and ASC payment systems for HCPCS G0429- Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy).
Use in addition: Q2026- Injection, radiesse, 0.1 ml, and Q2028 - Injection, sculptra, 0.5 mg
With a diagnosis of B20 - ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 7th, 2017 - Last Review/Update July 28th, 2017
When coding chronic migraines related to menstrual cramps, you must document that the patient has menstrual migraines. With ICD-10 there are a variety of migraines, including those that are neurologic, abdominal, and ophthalmologic based. You must also document whether the menstrual migraine (G43.82- and G43.83-) is intractable or not intractable, including ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 3rd, 2017 - Last Review/Update July 28th, 2017
If a mother uses alcohol or tobacco during pregnancy, be sure to assign O99.31 "Alcohol use complicating pregnancy, childbirth, and the puerperium."
Document the time of the encounter (such as the trimester), during childbirth, or during the puerperium.
NOTE: You also need to assign a secondary code from category F10- to identify manifestation of the alcohol use.
The following ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 3rd, 2017 - Last Review/Update August 1st, 2017
Diabetes mellitus is a significant complicating factor in pregnancy. Pregnant women who are diabetic should first be assigned a code from category O24 (diabetes mellitus in pregnancy, childbirth, and the puerperium) followed by the appropriate diabetes code(s) (E08-E13) from Chapter 4.
Diabetes mellitus due to underlying condition:
with proliferative diabetic retinopathy without macular edemaE08.3591 right eye
E08.3592 left eye
E08.3593 bilateral
E08.3599 unspecified eye
E08.36 with diabetic cataract
with diabetic macular edemaE08.37X1 right eye
E08.37X2 left eye
E08.37X3 bilateral
E08.37X9 unspecified eye
E08.39 with other diabetic opthalmic complication
with ...
Z Codes That May Only be Principal/First-Listed Diagnosis
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 2nd, 2017 - Last Review/Update July 28th, 2017
The following Z codes/categories may only be reported as the principal/first-listed diagnosis, except when there are multiple encounters on the same day and the medical records for the encounters are combined:
Z00 Encounter for general examination without complaint, suspected or reported diagnosis Except: Z00.6 Z01 Encounter for other special examination without complaint, suspected ...
By Wyn Staheli, Director of Research | Published February 16th, 2017
In order to arrive at a diagnosis and check for related complications, a healthcare provider needs to evaluate the patient condition. This may include:
History: This can include the patient's personal history as well as that of the patient's family.
Physical exam: The healthcare provider will try to rule out physical problems ...
Clinical Scenario for Coding with ICD-10-CM: Abdominal Pain
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 31st, 2017 - Last Review/Update August 2nd, 2017
Chief Complaint
• “My stomach hurts and I feel full of gas.”
History
• 47 year old male with mid-abdominal epigastric pain, associated with severe nausea & vomiting; unable to keep down any food or liquid. Pain has become “severe” and constant.
• Has had an estimated 13 pound weight loss over the past ...
By Evan M. Gwilliam, DC MBA BS CPC CCPC CPC-I QCC MCS-P CPMA CMHP | Published January 23rd, 2017 - Last Review/Update February 8th, 2019
Generating a differential diagnosis — that is, developing a list of the possible conditions that might produce a patient's symptoms and signs — is an important part of clinical reasoning. It allows a provider to perform appropriate testing to rule out possibilities and confirm a final diagnosis.
Courts view the formulation and documentation of a differential diagnosis as evidence of a physician's competence, prudence, and thoughtfulness.
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published January 20th, 2017 - Last Review/Update August 2nd, 2017
It is important to make a clear distinction between pre-existing conditions and conditions brought on by the pregnancy (gestational) or pregnancy related conditions.
Condition Detail: Was the condition pre-existing (i.e., present before pregnancy)?
Trimester: When did the pregnancy-related condition develop?
Casual Relationship: Establish the relationship between the pregnancy and the complication (e.g., preeclampsia).
Code examples:
O99.011 Anemia ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 30th, 2016
ICD-10 expands sections on poisonings and toxins.
When documenting injuries, include the following:
1. Episode of Care e.g. Initial, subsequent, sequelae 2. Injury site Be as specific as possible3. Etiology How was the injury sustained (e.g. sports, motor vehicle crash, pedestrian, slip and fall, environmental exposure, etc.)?4. Place ...
Documentating Diabetes Mellitus, Hypoglycemia and Hyperglycemia
By Find-A-Code | Published August 30th, 2016
The Increased Specificity in ICD-10-CM means documentation must more specific to accommodate the complications and combinations used. The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system.When documenting diabetes, include the following:1. Type e.g. Type 1 ...
Getting Ready for new ICD-10 Codes for Chiropractic
By ChiroCode | Published August 24th, 2016 - Last Review/Update March 5th, 2019
ICD-10-CM changes for 2017 include 1,974 new codes, 311 deleted codes, and 425 revised codes. Chiropractors, fortunately, are only affected by about 70 of these changes. And none of them are ground breaking. However, if you report deleted codes, your claims could be denied. Read more to see some examples of the changes
The final list of the new ICD-10- CM codes that become effective October 1, 2016 has been released. There are approximately 1600 changes to the code set, making up for the four years the ICD-10- CM codes have not had a complete update. For fiscal year (FY) 2017, updates to...
The 2017 ICD-10-CM and ICD-10-PCS code updates, including a complete list of code titles, are available on the 2017 ICD-10-CM and GEMs and 2017 ICD-10-PCS and GEMs webpages.
By Wyn Staheli, Director of Research | Published August 3rd, 2016
The Centers for Medicare & Medicaid Services (CMS) recently released the Proposed Rule regarding the updates to the ICD-10-CM and ICD-10-PCS code sets for Fiscal Year 2017 which begins October 1, 2016. Comments regarding the proposed ICD changes are due May 6th and CMS has stated that the Final Rule ...
When can I use “unspecified” codes? What about “other”?
By Dr. Evan Gwilliam | Published August 3rd, 2016
The official guidelines for ICD-10-CM define the conventions used in the code set. In section 1.A.6, we learn the following about some common abbreviations in the Tabular List:
Sports or camp or college physicals are exams requested by a parent or patient as a screening prior to going to camp or college or playing a sport. They vary in their scope. If the patient presents for a well child visit, and also needs their camp physical filled out,...
By Evan M. Gwilliam, DC MBA BS CPC CCPC NCICS CPC-I CCCPC MCS-P CPMA | Published July 28th, 2016
The facet joints are a pair of joints in the posterior aspect of the spine. Their proper name is zygapophysial joints. These joints can become inflamed due to trauma or overuse and cause back pain. This is called facet syndrome.
Unfortunately there was no ICD-9 code for this condition. However, diagnosis ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published July 22nd, 2016 - Last Review/Update August 4th, 2017
There are several types of testing that distinguishes between influenza virus types A and B and several changes in codes in 2016.
For direct observation to detect an infectious agent by immunoassay use:
87804- Infectious agent antigen detection by immunoassay with direct optical observation; Influenza.
If the specimen is tested for both Type ...
NAMAS: What You Need to Know About 2017 ICD-10 Updates
By Find-A-Code | Published July 19th, 2016
October 2016 brought us the implementation of ICD-10-CM. The switch from ICD-9-CM to ICD-10-CM brought with it a level of uncertainty and maybe even a little panic. With a great deal of preparation and planning in place, the implementation came and went without too much trouble. Now that we've settled ...
By Jessica Franzese, CPC, CPMA | Published July 8th, 2016 - Last Review/Update August 17th, 2017
October 2016 brought us the implementation of ICD-10-CM. The switch from ICD-9-CM to ICD-10- CM brought with it a level of uncertainty and maybe even a little panic. With a great deal of preparation and planning in place, the implementation came and went without too much trouble. Now that we've ...
By ChiroCode | Published June 28th, 2016 - Last Review/Update March 5th, 2019
In some places, the ICD-10-CM code set uses words we think we are familiar with. However, a review of the guidelines shows that some of these words have very specific definitions. Here are a few important ones to remember.
Are There Codes to Idenitfy the Left or Right Side of the Spine?
By Brandy Brimhall | Published June 27th, 2016
Q: We cannot find codes to identify the left or right side of the spine, such as with low back pain. Do we add digits 1 or 2 to the code to clarify left or right?
A: No. Codes pertaining to the spine are not specific to laterality. The codes do ...
May be a Payable Code for Dental Procedures under Medical Policy
By Christine Taxin | Published May 25th, 2016
The following list may be payable Codes for Dental Procedures under a patients Medical Policy. Be sure to verify with the payer for benefit coverage and exclusions.
ICD-10-CM Diagnosis Codes
B00.2 Herpesviral gingivostomatitis and pharyngotonsilitis
K00.0 Andontia
K00.1 Supernumerary Tooth
K00.2 Abnormalites of size and form of tooth
K00.3 Mottled Teeth
K00.4 Disturbances in tooth formation
K00.5 Hereditary ...
By Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC | Published May 13th, 2016 - Last Review/Update August 16th, 2017
One of the hardest parts when reviewing a medical record for coding or auditing is the determination of what conditions were addressed. Any condition that is taking into account or affects patient care, treatment or management should be documented and ultimately coded. However, the documentation still needs to support that ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 3rd, 2016
Find-A-Code has ICD-10-CM Official Guidelines!
The use of Guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA) and have been adopted for all healthcare settings. Guidelines are a set of rules developed to accompany and complement the official conventions and instructions provided within the code.
Find-A-Code understands how ...
By Bonnie G. Schreck, BS, CCS, CPC, COC, CCS-P, COBGC | Published April 25th, 2016
Influenza in ICD-10-CM is classified in the following categories:
J09 Influenza due to certain identified influenza viruses – this includes the following types:
o Avian
o Bird
o A/H1N1
o Swine
o Other influenza of animal origin (not bird/not swine)
J10 Influenza due to other identified influenza viruses – this includes any specified type not of animal ...
Generally, restorative dental treatments are not covered by a patient’s medical policy, except in cases of traumatic injury. However, if the patient exhibits oral side effects from a medical condition, an over-the-counter drug, a prescription medication or an illegal drug, then there is a good case to be made for...
By John Burns, CPC, CPC-I, CEMC, CPMA | Published March 25th, 2016 - Last Review/Update August 16th, 2017
Most payers do indeed recognize smoking and tobacco cessation services as a covered health insurance benefit. We have found that some providers perform these services without fully understanding the reimbursement opportunities, while others claim such services without adequately documenting to support them. Medicare, for example, will pay for two (2) ...
Congestive heart failure (CHF) is a common heart condition that exists in many patients. In ICD-9-CM coding, this was reported with code 428.0. In ICD-10-CM, if only CHF or congestive heart failure is documented, it would be reported with I50.9 Heart failure, and would not reflect the true extent of...
Coverage Criteria and Medical Necessity with Medicare
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 16th, 2016 - Last Review/Update August 3rd, 2017
In the absence of a systemic condition, treatment of mycotic nails may be covered. The treatment of mycotic nails for an ambulatory patient is covered only when the physician attending the patient's mycotic condition documents that (1) there is clinical evidence of mycosis of the toenail, and (2) the patient ...
Bones are typically resistant to bacterial colonization, but events such as trauma, surgery, the presence of foreign bodies, or the placement of prostheses may disrupt bony integrity, or a result of a spread after bacteremia, and lead to the onset of bone infection caused by an infectious organism, or osteomyelitis....
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 12th, 2016 - Last Review/Update August 4th, 2017
Reason for referral.
Tests administered, scoring/interpretation, and time involved.
Present evaluation.
Diagnosis (or suspected diagnosis that was the basis for the testing if no mental/neurocognitive illness was found).
Recommendations for interventions, if necessary.
Identity of person performing service.
...
For inpatient coding, there are times when the diagnosis(es) cannot be established at the time of admit or throughout the course of the admission. In these cases, they are documented in the medical record as “probable,” “suspected,” “likely,” “questionable,” “possible,” or “rule out” conditions. This guideline is true for certain...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published November 30th, 2015 - Last Review/Update August 8th, 2017
Z-codes are used for the reason of the encounter instead of the V codes, they are found in Chapter 21: Factors influencing health status and contact with health services (Z00-Z99). A corresponding procedure must accompany a Z code if a procedure is preformed.
Note: The chapter specific guidelines provide additional information about the ...
By Evan M. Gwilliam DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA, Christine Woolstenhulme, CMRS | Published November 13th, 2015
Chapter 21 of ICD-10-CM is titled "Factors Influencing Health Status and Contact with Health Services". They cover codes in the categories from Z00 to Z99. This chapter is used for encounters with health care providers where the patients have no current illnesses or injury. For example, a patient may present at ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 20th, 2015
There has been some confusion on Sprain vs. Strain and how to find them in ICD-10-CM. They are now split in two separate code ranges and Injury is now related to the anatomic location specific to the injury.
It will help to remember the following information when searching for Strains vs. ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 5th, 2015
ICD-10 is finally here, it is no longer a myth. Here are a few suggestions to help you with ICD-10 and resources available for you.
Check out Find-A-Code, if you are not familiar with this on-line tool, you will quickly find this to be your most valuable resource during your transition ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 30th, 2015
It is finally here, Now what? For all of our customers we want to offer some Mapping Instructions, and show you how to locate the correct code ICD-10 Codes with Find-A-Code and InstaCode Institute’s resources. Be sure you understand the structure of ICD-10 and what a complete code looks like. ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 25th, 2015
V-codes will be a part of the past, you will be using encounter codes with ICD-10-CM.
Lets take a look at how you will code V20.2 Routine infant or child health with ICD-10-CM.
ICD-10-Cm will now use Z-codes which represent the reason for the encounter. If a procedure is performed, you must use ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 17th, 2015
Specifying anatomical location and laterality required by ICD-10 is easier than you think. This detail reflects how physicians and clinicians communicate and to what they pay attention - it is a matter of ensuring the information is captured in your documentation. In ICD-10-CM, there are three main categories of changes:
...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 17th, 2015 - Last Review/Update August 7th, 2017
ICD-9 used separate “E codes” to record external causes of injury. ICD-10 better incorporates these codes and expands sections on poisonings and toxins.
When documenting injuries, include the following:
1. Episode of Care e.g. Initial, subsequent, sequelae
2. Injury site Be as specific as possible
3. Etiology How was the injury sustained (e.g. sports, ...
By Daniel Schwartz | Published August 28th, 2015 - Last Review/Update February 3rd, 2017
Pediatricians are great at making boo-boos less painful for their patients, but without proper planning, they may not be able to alleviate the potential pains associated with the upcoming ICD-10 transition. What is ICD-10 Exactly and Why is This Transition Happening Now? Starting October 1st, providers will no longer be...
By | Published August 19th, 2015 - Last Review/Update January 27th, 2017
By Dr. Evan Gwilliam
Using a Medicare Local Coverage Determination (LCD), and the General Equivalence Mappings (GEMs) as a starting point, I will attempt in this article to predict which ICD-10-CM codes will be approved for the secondary cervical diagnoses which Medicare uses now. (By the way, I just use the ...
Attention Dentists: How does the switch to new diagnostic codes this year affect you?
By By Greg Alterton, CDA Dental Benefit Plan Specialist | Published August 19th, 2015
Increasingly, dental plans are deferring to medical benefit carriers on certain dental procedures that can be claimed as medical procedures with patients’ medical plans. More and more, these medical plans are paying for not only surgical dental procedures, but some preventive dental services as well.
In submitting claims to medical plans, ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 17th, 2015
Documentation assessment and gap analysis is important in ICD-10-CM/PCS. Clinical documentation will also affect code assignment and relative weight associated with payment. To read more information on problem areas with documentation issues read AHIMA's article.
...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 13th, 2015
UHIN offers an ICD-10 Peer Support Group.
Did you know that your peers can be one of your best education resources? To encourage collaboration within the community, we have set up a recurring conference call where everyone can trade tips and tricks for ICD-10 preparation. These are open calls- just ...
By Melinna Giannini | Published August 10th, 2015 - Last Review/Update January 27th, 2017
This article is coming out before the payers have told us which ICD-10 codes will be used for claim submission. However, we have access to the same code set that they do, therefore this is an educated guess at which codes might used by DCs for the lumbar spine. The ...
Can Chiropractors Finally Code a "Subluxation" in ICD-10?
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
There is a word that has long been held as sacred to the Chiropractic profession. It is the so-called vertebral “subluxation.” Throughout ICD-9, which is the diagnostic code set used on claims for the last thirty years, the term “subluxation” is used to describe a partial dislocation,” which is not how it is defined by many Chiropractors. Medicare ...
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
Beginning October 1, 2015 all claims for health care services in the United States must use ICD‑10 diagnosis codes. ICD‑9 has been the standard since 1979, but has outlived its usefulness. Because of its structure, ICD‑10 provides better data for research and statistical analysis than ICD‑9. Although there is no national mandate to report ...
Claims Processing Rules for ESAs Administered to Cancer Patients for Anti-Anemia Therapy (Rev. 3085, Effective: Upon Implementation of ICD-10)
By Jared Staheli | Published July 9th, 2015
The national coverage determination (NCD) titled, “The Use of ESAs in Cancer and Other Neoplastic Conditions” lists coverage criteria for the use of ESAs in patients who have cancer and experience anemia as a result of chemotherapy or as a result of the cancer itself. The full NCD can be ...
Oral Anti-Emetic Drugs Used as Full Replacement for Intravenous Anti-Emetic Drugs as Part of a Cancer Chemotherapeutic Regimen (Rev. 2931, 07-07-14)
By Jared Staheli | Published July 8th, 2015
See the Medicare Benefit Policy Manual, Chapter 15, and the National Coverage Determination (NCD) Manual, Section 110.18, for detailed coverage requirements.
Effective for dates of service on or after January 1, 1998, Medicare Part B (including (institutional claims processed by Part A Medicare Administrative Contractors (MACs) and physician/supplier claims processed by ...
Policy for Intensive Behavioral Therapy for Obesity (Rev. 3232, 01-05-15)
By Jared Staheli | Published July 7th, 2015
For services furnished on or after November 29, 2011, Medicare will cover Intensive Behavioral Therapy for Obesity. Medicare beneficiaries with obesity (BMI ≥30 kg/m2 ) who are competent and alert at the time that counseling is provided and whose counseling is furnished by a qualified primary care physician or other ...
Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages for Screening for Hepatitis C Virus (HCV) (Rev. 3215, 01-05-15)
By Jared Staheli | Published July 7th, 2015
Contractors shall use the appropriate claim adjustment reason codes (CARCs), remittance advice remark codes (RARCs), group codes, or Medicare summary notice (MSN) messages when denying payment for HCV screening, HCPCS G0472:
• Denying services submitted on a TOB other than 13X, 71X, 77X, or 85X:
CARC 170 - Payment is denied when ...
Diagnosis Code Reporting for Screening for STIs and HIBC to Prevent STIs (Rev. 2476, 02-27-12)
By Jared Staheli | Published July 6th, 2015
A claim that is submitted for screening chlamydia, gonorrhea, syphilis, and/or hepatitis B shall be submitted with one or more of the following diagnosis codes in the header and pointed to the line item:
a. For claims for screening for chlamydia, gonorrhea, and syphilis in women at increased risk who are ...
In order to understand diabetes coding in ICD-10, it’s worth making a comparison of the structural differences between ICD-9-CM and ICD-10-CM.
Diabetes mellitus (DM) codes in ICD-10-CM are combination codes that include the type of DM, the body system affected, and the complication affecting that body system as part of the code description. Subcategory levels first ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 30th, 2015 - Last Review/Update August 8th, 2017
More than one external cause code is required to fully describe the external cause of an illness or injury. The assignment of external cause codes should be sequenced in the following priority: If two or more events cause separate injuries, an external cause code should be assigned for each cause.
The ...
Anatomy of ICD-10 and New Features: Finding S52.131A
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 11th, 2015 - Last Review/Update February 3rd, 2017
We are used to the simple ICD-9-CM Diagnoses Codes where there are only are 3–5 digits. Lets take a look at how an ICD-10 code is broken down.
ICD-10-CM, these Diagnosis Codes can be as short as 3 digits or as long as 7 digits; furthermore, ICD-10 consists of Alphabetical and ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 6th, 2015 - Last Review/Update August 8th, 2017
The 7th character is used in certain chapters (e.g., Obstetrics, Injury, Musculoskeletal, and External Cause chapters). However, it is not used in every chapter and may have a different meaning depending on the section where it is being used. One thing that is consistent, is that it must be used in the 7th character ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published May 6th, 2015 - Last Review/Update August 8th, 2017
The difference between NEC and NOS is very specific and not to be confused as they are two very different abbreviations.
NEC - When a specific code is not available for a condition, the Index directs the coder to the “other specified” code in the Tabular List. NEC is used to indicate the ...
By Wyn Staheli | Published March 26th, 2015 - Last Review/Update July 27th, 2017
The Diagnostic and Statistical Manual for Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. It is generally accepted as the authoritative guide for the diagnosis of mental disorders. This FAQ article was created to address some commonly asked questions about DSM coding and clear up some common misconceptions.
Billing Imminuzation for Pneumococcal, Influenza, and Hepatitis B with Medicare
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published March 9th, 2015 - Last Review/Update August 9th, 2017
The current diagnosis pointer for, Influenza, Pneumococcal or Hepatitis B vaccines is ICD-10-CM code Z23. Listed are tips for coding, and also the diagnosis pointers used for claims previous to 10/01/15:
Influenza: G0008
Procedure codes:
90630
90653-90662
90672-90674
90685-90688
Medicare codes:
Q2034-Q2039
Expired diagnosis code:
V04.81
Pneumococcal: G0009
Procedure codes:
90670
90732
Expired diagnosis code:
V03.82
Hepatitis B: G0010
Procedure codes
90739-90747
Expired diagnosis code
V05.3
Both Influenza and Pneumococcal Vaccines received in same visit: G0008 with G0009
Procedure codes:
(See previous)
Expired diagnosis code:
V06.6 (effective 10/01/06 - 09/30/15)
Extra Tips:
Be sure ...
What is the difference between ICD-9-CM and ICD-10-CM
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 23rd, 2015
ICD-10-CM uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM (for example, ICD-10-CM has the same hierarchical structure as ICD-9-CM).
The 7th character in ICD-10-CM is used in several chapters (for example, the Obstetrics, Injury, Musculoskeletal, and External Cause chapters). ...
Underdosing - a New Clinical Concept in ICD-10 codes T36 – T50
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published February 15th, 2015 - Last Review/Update March 1st, 2016
T36-T50 Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)
Underdosing is a clinical concept new to ICD-10. Underdosing identifies situations referring to the practice of a patient taking less medication as prescribed by a physician, or a physician prescribing less than what is prescribed by ...
OASIS Data to be Submitted via Assessment Submission and Processing (ASAP) System Effective Jan 1, 2015
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published December 4th, 2014 - Last Review/Update March 1st, 2016
Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the national OASIS Assessment Submission and Processing (ASAP) system. With the implementation of the OASIS ASAP system, Home Health Agencies will no longer submit OASIS assessment data to CMS via their state databases. To access the ...
By | Published October 29th, 2014 - Last Review/Update January 30th, 2017
Each new year brings a bundle of surprises in terms of changes and updates that practices must learn and implement. In effort to aid in the preparation of this year, here are some common helpful tips that you might follow in order to best manage your workload ahead.
-Evaluate fees: Fee schedules ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 17th, 2014 - Last Review/Update January 30th, 2017
The following is a short list of some other handy ICD-10 codes:
M76.50 Patellar tendinitis, unspecified kneeM76.51 Patellar tendinitis, right kneeM76.52 Patellar tendinitis, left kneeM05.33 Rheumatoid arthritisM15.9Polyosteoarthritis, unspecified (generalized osteoarthritis NOS)M16.10 Unilateral primary osteoarthritis, unspecified hipM54.40 Lumbago with sciatica, unspecified sideM54.41 Lumbago with sciatica, right sideM54.42 Lumbago with sciatica, left sideM54.6 Pain in the thoracic spineM54.9Dorsalgia, unspecified (backache NOS, back ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017
Don't do that!
The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is 6 characters, a placeholder X must be used to fill in the empty characters.
Remember:
You may be using the placeholder "X" to complete a code. Be sure ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017
Acupuncture services are often reimbursed for the treatment of headaches. For examples on headache codes and coding for headaches with ICD-10, visit HealthCMi
...
#2 DRIP Line ICD-10 -CM Did you know... ICD-10-CM/PCS Examples: Structural Differences
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published October 8th, 2014 - Last Review/Update August 9th, 2017
The examples below show the structural differences between ICD-9-CM and ICD-10-CM/PCS.
ICD-9-CM Diagnoses Codes:
3–5 digits
First digit is alpha (E or V) or numeric
Digits 2–5 are numeric; and Decimal is after third digit
Examples:
496 – Chronic airway obstruction, Not Elsewhere Classified (NEC)
511.9 – Unspecified pleural effusion
V02.61 – Hepatitis B carrier
ICD-10-CM Diagnoses Codes:
3–7 digits
Digit 1 is ...
By | Published May 2nd, 2014 - Last Review/Update January 25th, 2017
On the evening of April 30th, the release of the 2015 Inpatient Prospective Payment System Proposed Rule included three separate references to the implementation of ICD-10:
1. "The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015. After that date, we will collect non-electronic health record-based quality measure data coded only in ICD-10-CM/PCS." - page 648
2. "ICD-10 will officially be implemented on October 1, 2015." - page 1065
3. "ICD-10-CM/PCS will officially be implemented on October 1, 2015." - page 1074
Today, May 2, 2014, CMS released the following statement:
ICD-10 Guidelines that Chiropractic Physicians Should Remember
By | Published January 28th, 2014 - Last Review/Update January 27th, 2017
Depending on the publisher, there are about 30 pages of guidelines in the ICD-10-CM code set. The bulk of these guidelines, from section 1.C, are chapter-specific.
Chiropractic physicians typically use codes from just four or five of the 21 chapters available in ICD-10-CM. These include, but are not necessarily limited to, ...
How do I know which ICD-10 codes payers are going to like?
By | Published November 26th, 2013 - Last Review/Update January 27th, 2017
One of the biggest questions doctors have is “Which codes will I actually use when ICD-10 kicks in on October 1, 2014?” This is the great mystery. Fortunately we have access to the same code set that payers will be using as they determine which codes they like to see. ...
ICD-10 Coding Possibilities for Chiropractic Physicians
By Evan M Wsilliam, DC, CPC, CCPC, NCICS, CCCPC, CPC-I, MCS-P, CPMA | Published September 11th, 2013 - Last Review/Update January 27th, 2017
Right now, it’s hard to say which ICD-10 codes third-party payers will select as medically necessary, but we can make an educated guess based on information from a few sources. More detail is expected from Medicare before the end of 2013. For doctors of chiropractic (DCs), the natural place to start is with the relatively short list of frequently used ICD-9-CM codes for submitting claims. We’ll investigate a handful of diagnosis codes that Medicare recognizes as medically necessary and explore ICD-10-CM code possibilities.
By | Published June 14th, 2013 - Last Review/Update January 27th, 2017
Maybe ICD-10 will just go away...
Or maybe not. In case you have not heard, the ICD-9 codes that you have been using on claim forms since the late 1970s will cease to exist as of October 1st, 2014. You may have also heard that the entire country was supposed to switch ...
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September 25th, 2019
August 29th, 2019 — ICD-10-CM Changes Effective October 1, 2019
Are you aware of the ICD-10-CM code changes set take effect as of October 1, 2020? Do any of them apply to your organization? Which of them will be assigned as an HCC? What are the documentation and coding guidelines applicable to them and which guidelines are changing or being ...
Chiropractic Manipulative Treatment (CMT) Coding and Documentation (Part 1)
The most used codes in chiropractic are 98940, 98941, 98942, and 98943. In this webinar, Dr. Gwilliam will go over the fundamentals of these codes and make sure you are proficient with them. They probably play a bigger part of your practice than any other code, so it is worth it to make sure you are reporting them correctly. By the end of this presentation you will be able to diagnose, document, and code properly for CMT, as well as avoid common mistakes.
The #1 most overlooked injury in PI, and it is found in over 90% of all cases
Presented by Tom Grant Jr. DC
December 11, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET *How to recognize this injury *The most effective documentation terms to use *The best combination of ICD-10 codes to validate it
Register here: https://attendee.gotowebinar.com/register/8562161323381676035
...
Documenting Diagnoses Like a Peer Reviewer (Part 2)
Chiropractors only use a fraction of the codes available in the ICD-10 code set. But each group of diagnoses have things to teach us based on coding guidelines, objective findings, standards of care, and more. In this presentation Dr. Gwilliam will review the most commonly used diagnoses (by chiros) and make sure you know everything that should be documented in order for a peer reviewer to walk away satisfied.
Documenting Treatment Plan and Goals That Actually WORK - November 20th, 2018
Dr. Friedman will discuss the need to document Treatment Plan and Goals and what we MUST document and what we SHOULD document. He'll also demonstrate how we can do this in the least amount of time and with the least amount of effort.
Join Brandon Leavitt as we master the anatomy of the foot and ankle and common diseases and injuries which are found with this joint. We will also cover how these terms are described in ICD-10-CM.
When an outsider looks at your records, you want them to easily find exactly what they are looking for. Let ICD-10 codes guide you as you choose the words to use in the Diagnostic Statement in your initial encounter. Don't assume a reviewer can interpret your clinical findings. Spell it out for them. Dr. Gwilliam, ICD-10 guru and all around good guy, will show you how to do that is this webinar.
Join Brandon Leavitt in this webinar all about the heart. He'll review the anatomy of the heart (including functionality) and the guidelines specific to ICD-10-CM code selection for specific diseases, injuries, or other conditions.
In this webinar, Brandon will review the bones and major joints of the upper extremities (arm, forearm, wrist, hand, and digits), as well as their supporting structures and how they are affected by injury, disease, and other conditions.
In this webinar, Brandon Leavitt will review the anatomy of wounds from injury, disease, and other conditions and the proper ICD-10-CM coding for them. A review of pressure and non-pressure, and venous stasis ulcers, burns, corrosions, neoplasms, and other diseases affecting the integument will be presented.
Radiology Coding Auditing Dexa Scans for Osteoporosis & Mammograms for the Breast
Learn important coding tips when billing Dexa scans (for osteoporosis) and mammograms (for breast diseases). Coders and clinicians specializing in Radiology, Family Practice, Orthopedics, and OB-GYN will all find useful information for their practice. This is a follow-up from the webinar "Diagnosis of osteoporosis and diseases of the breast".
Time for a little refresher. You might think you know ICD-10 now that it has been around for a while. The guidelines teach which codes go first, how certain key words are defined, and ensure that you submit the right information on your claim forms. This webinar will be taught by Dr. Evan Gwilliam who helped write ChiroCode's ICD-10 book and is a certified ICD-10 instructor.
Diagnosis of Osteoporosis and Diseases of the Breast
Osteoporosis diagnosis and breast diseases will be covered in this webinar, benefiting coders and clinicians specializing in Radiology, Family Practice, Orthopedics, and OB-GYN. This will prepare participators for the following Find-A-Code webinar on radiology coding, which will explain coding/billing for Dexa scans to detect osteoporosis, and mammogram screening for breast evaluation.
Diagnosis coding is difficult when clinician documentation does not match up with the definitions found in the ICD-10-CM code set. Find-A-Code's anatomy images educate both coders and students - bridging the gap between coders and clinicians while simplifying code selection.
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to add
Acupuncture services to a Chiropractic office. Topics include how to find and employ acupuncturists, CPT/ICD-10 coding, 15 minute increments vs the 8 minute rule, how to bill for office visits on same day as acupuncture and how to create an acupuncture billing and coding policy manual.
Ever wonder what an auditor is looking for when they review your surgical coding? Join Aimee and review the basic rules and documentation requirements. We’ll tear apart a couple of operative reports, code them, review NCCI edits, modifiers, and more. Get an idea of how you are doing and things you may want to incorporate into your practice to be better prepared when an audit comes your way. Also, we’ll review our cool Code-A-Note tool and how it can help you locate CPT and ICD-10-CM codes quickly. This tool is great for new coders, coders new to a specialty, difficult coding situations, or anyone who just wants a second opinion on their code options.
Recently, Medicare stated that they expected chiropractic care to be “episodic” in nature. Find out what Medicare expects from your treatment plan to justify medical necessity. How many treatments is too much? What are they looking for in your care? Medicare and ICD-10 Guideline changes in 2017 have resulted in massive audits taking place across the country. Many calls are coming in pertaining to denials and audits. Most are because the doctor and staff are unaware of the regulation changes. Mario Fucinari, DC, CCSP, CPCO, MCS-P, MCS-I is uniquely qualified as being still in active practice, a Certified Medical Compliance Specialist, Certified Compliance Officer and a member of the Carrier Advisory Committee.
New ICD-10 Codes for Chiropractors and the Beginning of ICD-10 Audits
Presented by Evan Gwilliam DC MBA BS CPC NCICS CCPC CCCPC CPC-I MCS-P CPMA
September 27, 2016
Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 ET
The ICD-10 documentation grace period ends on October 1st 2016. Are your records good enough? Do you know what the new codes are the chiropractors need to use? Have you got rid of the codes that have been deleted for 2017? Find out about all this and more in this webinar.
ChiroCode worked hard to update and revise and enhance our ICD-10 book. It has been expanded, but also refined. In this webinar find out how to use your 2016 ICD-1
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