Tag Archives | Cdc

The Hidden Tragedy of the Opioid Crisis

When President Trump declared the opioid crisis a public health emergency Thursday, he noted that “last year we lost at least 64,000 Americans to overdoses.” He is not incorrect. A preliminary analysis for 2016 from the Centers for Disease Control and Prevention estimated the toll at 64,070, up from 52,898 in 2015. What rarely gets […]

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CMS Tackles Opioid Prescribing

The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing guidelines. On January 5, 2017, the agency released a statement justifying this action. Because of  “the growing body of evidence on the risks of misuse […]

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CMS Updates ICD-10 Quality Measures, More from C&M Meeting

The Centers for Medicare and Medicaid Services (CMS) has released an update to the ICD-10 and Quality Measures website. The home page covers ambulatory surgical centers, hospital inpatient and outpatient, Centers for Disease Control (CDC) and National Healthcare Safety Network (NHSN) Surgical Site Infections (SSI) Measures, CMS outcome and payment measures, Agency for Healthcare and […]

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COPD and Pneumonia: Code First or Code Also?

One subject brought up several weeks ago on an edition of Talk Ten Tuesdays was the sequencing of J44.0, chronic obstructive pulmonary disease (COPD), with acute lower respiratory infection and pneumonia. Guest Stacey Elliot referred to the Coding Clinic from the third quarter of 2016, which says: “based on the instructional note, the COPD must […]

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CDC Ends Freeze On New ICD-10 Codes

A total of 1,900 codes and 3,651 hospital inpatient procedure codes will be added for fiscal year 2017.

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338.3 Example Boosts Your Non-Chemo Encounter Coding Savvy

Be sure your coding complies with ICD-9 official guidelines for pain management.

If you don’t know when to check ICD-9 official guidelines, you may have just a 50-50 chance of choosing the proper order for your diagnosis codes.

Case in point: Patients may present to the office for treatment related to pain caused by a neoplasm. In such cases, you will need to determine, which diagnosis codes to report, and you will need to decide what order to list the codes in on your claim. With that in mind, consider how you should code the scenario below.

Start by Examining the Neoplasm-Related Pain Case

Read the following scenario and determine proper ICD-9 coding based on the information given. You’ll find a helpful hint on which section of the official guidelines to review if you get stuck.

Scenario: The physician documents that a patient with lung cancer (middle lobe, primary malignant neoplasm) presented to the office for the purpose of pain management. The pain is documented as acute and caused by the neoplasm.

Hint: See section I.C.6.a.5 of the Official Guidelines for instructions on properly coding these sorts of encounters. The CDC posts ICD-9 guidelines online at: www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm

Next, Determine Which Neoplasm and Pain Codes Apply

For this scenario, before you can decide what order to put the codes in, you will need to decide which codes to report.

Neoplasm: For a primary malignant neoplasm of the lung’s middle lobe, you should report 162.4 (Malignant neoplasm of middle lobe bronchus or lung), says Denae M. Merrill, CPC, HCC coding specialist in Michigan.

Pain: To choose the proper pain diagnosis code, you want to be sure you keep in mind that the neoplasm is the cause. The ICD-9 index entry for pain has several subentries to consider:

  • Cancer associated
  • Neoplasm

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Are you sure that your coding complies with ICD-9 official guidelines for pain management?

If you don’t know when to check ICD-9 official guidelines, you may have just a 50-50 chance of choosing the proper order for your diagnosis codes.  Patients may present to the office for treatment related to pain caused by a neoplasm.  In such cases, you will need to determine which diagnosis codes to report and you will need to decide what order to list the codes in on your claim.  With that in mind, consider how you should code the scenario below.

Start by Examining the Neoplasm-Related Pain Case

Read the following scenario and determine proper ICD-9 coding based on the information given.  You’ll find a helpful hint on which section of the official guidelines to review if you get stuck.

Scenario: The physician documents that a patient with lung cancer (middle lobe, primary malignant neoplasm) was presented to the office for the purpose of pain management.  The pain is documented as acute and caused by the neoplasm.

Hint: See section I.C.6.a.5 of the Official Guidelines for instructions on properly coding these sorts of encounters. The CDC posts ICD-9 guidelines online at: http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm

Next, Determine Which Neoplasm and Pain Codes Apply

For this scenario, before you can decide what order to put the codes in, you will need to decide which codes to report.

Neoplasm: For a primary malignant neoplasm of the lung’s middle lobe, you should report 162.4 (Malignant neoplasm of middle lobe bronchus or lung), says Denae M. Merrill, CPC, HCC coding specialist in Michigan.

Pain: To choose the proper pain diagnosis code, you want to be sure you keep in mind that the neoplasm is the cause. The ICD-9 index entry for pain has several subentries to consider:

  • Cancer associated
  • Neoplasm related (acute) (chronic)
  • Tumor associated.

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C34 — Pay Attention To Location for Malignant Neoplasm of Main Bronchus

ICD-9 2011 and ICD-10 2011 both have coding options for a malignant neoplasm of the main bronchus. Both indicate that the codes are appropriate for malignant neoplasms of the carina or hilus of lung.
What’s different: ICD-9 2011 includes simply 162.2…

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Get a Glimpse at ICD-10 Codes for Cough, Back Pain, and More

Wrap your brain around using letters in your diagnosis codes.

If you aren’t curious about how the ICD-9 codes crosswalk to ICD-10, maybe you should be.

“The transition date for ICD-10 codes is Oct 1, 2013,” stressed CMS’s Stewart Streimer…

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