Hot Coding Topics

ICD-9 2011 Diagnosis Coding: New Ectasia Codes Come Oct. 1

Check out V13.65 for corrected congenital heart malformations.

Each October you’re faced with new ICD-9 codes to add to your diagnosis arsenal. 2011 is no exception, with new ectasia, congenital malformation, and body mass index (BMI) codes you’ll need to learn. Take a look at the proposed changes that will affect your cardiology practice, so that you’re ready when fall rolls around.

End Your Ectasia Hunt at 447.7x

The proposed changes to ICD-9 2011 add four codes specific to aortic ectasia, which could be among the most significant changes for cardiology coders.

“Ectasia” means dilation or enlargement, and aortic ectasia often refers to an enlargement that is milder than an aneurysm. But ICD-9 2010 does not distinguish ectasia from aneurysm, linking aortic ectasia to 441.9 (Aortic aneurysm of unspecified site without mention of rupture) and 441.5 (Aortic aneurysm of unspecified site, ruptured).

The proposed 2011 codes are specific to aortic ectasia and are based on anatomic site:

  • 447.70 — Aortic ectasia, unspecified site
  • 447.71 — Thoracic aortic ectasia
  • 447.72 — Abdominal aortic ectasia
  • 447.73 — Thoracoabdominal aortic ectasia.

New Corrected Congenital Malformations Code

A number of new codes deal with congenital malformations of the heart and circulatory system. Code V13.65 (Personal history of [corrected] congenital malformations of heart and circulatory system) will be “very useful to our practice,” says Janel C. Peterson, CPC, with Alegent Health Clinic Heart and Vascular Specialists in Omaha, Neb.

Add BMI V Codes to Your E/M Arsenal

The ICD-9 proposal has “expanded the body mass index (BMI) codes to demonstrate higher BMIs with five new codes,” notes Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, with CRN Healthcare Solutions in Tinton Falls, N.J.

You’ll need to stop using V85.4 (Body Mass Index 40 and over, adult) on Oct. 1 and start...

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August 12, 2010
Provider News

Diagnosis Coding: Here’s How To Decode Your Physician’s Notes

If the doctor does not circle a diagnosis, it may be up to you to find one.

Don’t let an incomplete superbill damage your chances of submitting an accurate claim. If the doctor in your office fails to indicate the ICD-9 code for the condition that he treated, you should read through his documentation to find which diagnoses you should report.

Open the Notes When You Have to — and Even When You Don’t

Suppose your physician hands you a superbill with the procedures circled and the diagnosis left blank.

You could ask the physician which diagnosis to report, or you could examine the documentation yourself. If your office has a policy that includes “coding by abstraction” by certified/qualified coders, then submitting charges based on what is supported (documented) in the note is appropriate, says Barbara J. Cobuzzi, MBA, CPC, CPCH,CPC-P, CENTC, CHCC, with CRN Healthcare Solutions in Tinton Falls, N.J. The physician should be signing off on these charges as part of your internal policy.

Some practices choose to review the documentation and compare it against any diagnoses recorded on the superbill, even when they aren’t required to. This ensures that the documentation matches the code selection every time.

When in Doubt, Confirm With the Physician

If you are new at coding diagnoses from the physician’s notes, you should doublecheck your code selections with the practitioners before submitting your claims.

“Until a coder feels comfortable with the ICD-9 books and the codes used more often in their office, it’s a good idea to run the choices by a clinician,” says Suzan Berman, CPC, CEMC, CEDC, senior manager of coding and compliance with the Physician Services Division of UPMC in Pittsburgh. “You never want to give a patient a disease or symptom they don’t have  ” or one more...

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June 16, 2010
Provider News

CMS Changes Conversion Factor Yet Again

Plus: Look for an increase in your DEXA scan reimbursement.

The bad news: Your carrier won’t be paying your claims using the conversion factor of $36.0846 anymore.

The good news: CMS is only changing the conversion factor by less than a penny, making it $36.0791, according to CMS Transmittal 700, issued on May 10. MACs will use this 2010 conversion factor to calculate your payments, but keep in mind that after May 31, you’re still due to face a 21 percent pay cut unless Congress intervenes. Keep an eye on the Insider for more information on whether Congress steps in...

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May 16, 2010
Audit / Provider News

Auditors Review Your Notes Based on the Regs as of the Service Date

auditorIf you performed a consult in 2006, the auditor will use 2006 guidelines — not today’s rules.

Most Part B practices have grown accustomed to tucking consult regulations into the backs of their minds, since Medicare no longer pays for...

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May 12, 2010
CMS / Hot Coding Topics / ICD-9

CMS Announces Over 100 New ICD9 Codes, Effective Oct. 1

Get ready for the dawn of new jaw pain, BMI codes, among others.

If you’ve got high hopes that you’ll benefit from many new ICD-9 codes starting this fall, CMS delivers, with over 130 new diagnosis codes debuting on Oct....

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May 5, 2010
Hot Coding Topics

3 Coding Options Resolve Balloon Sinuplasty Questions

Your solo dilation coding will get easier come 2011.

With no dedicated code for a balloon sinuplasty, you’re not alone if you’ve wondered how to code endoscopic sinus surgery involving the newer tool.

You, however, can confidently navigate to the...

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April 26, 2010
CMS / Hot Coding Topics / modifier PA / modifier PB / modifier PC / modifier TC / Modifiers / surgery

Surgical Modifiers: Protect Yourself From Instant ‘PC’ Claim Denials

Don’t let ‘wrong surgery’ modifier mistakes stall your reimbursement.

You use modifier TC for the technical component of a test. So logically, you should use modifier PC for the professional component, right? Wrong. But many coders are making that mistake...

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March 18, 2010
Coder's Cranium / ICD-9 / MAC

ICD-9 Coding: Stop Asking ‘Which Diagnosis Code Will Get My Claim Paid?’

Assigning an ICD-9 code merely to get your claim paid could land you in legal hot water. Medical coders face a lot of questions each day in the course of their work, but one question you should not be asking is “which diagnosis code should I put on this claim if I want to collect?” When [...] Related articles:

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  3. Dx Coding Moves That Stop Denials for Chronic Pain ClaimsTip: Code prior conditions in these cases. Imagine your pain...

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February 21, 2010
CPT 2010 / Hot Coding Topics

CPT 2010 Update: Tally Up Common Audiology Code Groups Into Single Codes

Plus, add this new tympanometry code to your cache next year. One of CPT 2010’s initiatives is to move several codes typically performed together into one code. Check out these new audiology testing codes and understand the rationale before Jan. 1 hits. For instance, if your physician performs a vestibular evaluation in 2010, you will report new [...] Related articles:

  1. Diagnostic Radiology ICD-9 Code Update: New Mammo Code 793.82 New code 793.82 shakes up the whole 793.x range...
  2. Can a Sleep Study Code Describe an Awake Test? Question: A sleep study was ordered for a patient...
  3. Bundle of His Recording Coding ChallengeQuestion: How should I report right atrial pacing and recording...

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December 5, 2009