General / Hot Coding Topics / ICD-10

Qualedix, Inc. Partners with the Coding Institute to Bring Enhanced Quality and Education to its Managed Services Solution for ICD-10 Testing

Naples, FL (June 15, 2011) –Qualedix, an advanced healthcare testing organization, today announced it has partnered with the Coding Institute, LLC, a company dedicated to offering accurate healthcare solutions, that will provide native ICD-10 coding expertise and educational services to the industry leading Simplicedi testing platform.

The combined market offerings enable greater accuracy, speed and a true clinical approach to tackling the arduous task of testing thousands of new ICD-10 codes for providers and payers alike.

“At Qualedix, we strive for excellence in our data solutions for the industry and clinical knowledge is paramount to effectively remediate and test ICD-10 changes across the healthcare industry. The Coding Institute brings to a new echelon of quality and expert knowledge to better effectively serve the market through our testing managed services,” said Mark Lott, CEO of Qualedix. “Also, all of our clients need education to assist in the transition period and we are proud to have TCI as our education and training partner.”

“The Coding Institute is excited about the opportunity to partner with Qualedix to provide unmatched testing and training to help healthcare professionals implement ICD-10 compliantly and efficiently,” said Jennifer Godreau, BA, CPC, CPMA, CPEDC, Director of the SuperCoder.com and Consulting & Revenue Cycle Solutions divisions of the Coding Institute.  “As the healthcare industry’s most advanced ICD-10 testing and education methodology, this managed services solution identifies key areas of focus for hospitals, insurers, and providers and allows us to prevent incorrect coding and revenue losses.”

About Qualedix

Qualedix is a professional healthcare IT quality assurance and software testing firm delivering outsourced managed testing services that leverage our expertise in healthcare and software development lifecycles. Qualedix has developed highly strategic methodologies and techniques designed to deliver critical, cost-effective solutions for 5010 and ICD-10 with highly technical testing experts, healthcare business acumen,...

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June 22, 2011
Coder's Cranium / General / Hot Coding Topics

CMS Proposes New Glaucoma, Skin Cancer, Dementia Codes

 

Many new codes abound in final update to proposed ICD-9-CM code set

If you’ve felt that your skin cancer diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final. The list of ICD-9 changes was recently posted to the CMS Website, and includes the final full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, CMS will only add new ICD- 9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10.

 

Seek Out Skin Cancer Changes

You’ll find a significant expansion to the 173.x (Other malignant neoplasm of skin) categories, including changes to 173.0x (…Skin of lip), 173.1x (Eyelid, including canthus), 173.2x (Skin of ear and external auditory canal), 173.3x (Skin of other and unspecified parts of face), 173.4x (Scalp and skin of neck), 173.5x (Skin of trunk, except scrotum), 173.6x (Skin of upper limb, including shoulder), 173.7x (Skin of lower limb, including hip), 173.8x (Other specified sites of skin), and 173.9x (Skin, site unspecified).

 Among these changes, for example, you’ll find the following new codes to delineate various types of skin cancers:

  • 173.60 —Unspecified malignant neoplasm of skin of upper limb, including shoulder
  • 173.61 — Basal cell carcinoma of skin of upper limb, including shoulder
  • 173.62 — Squamous cell carcinoma of skin of upper limb, including shoulder
  • 173.69 — Other specified malignant neoplasm of skin of upper limb, including shoulder.

 The changes in the other skin cancer categories referenced above follow this pattern, with the fifth digit of “0” referring to an unspecified malignant neoplasm, “1” denoting a basal cell cancer, “2” referring to a squamous cell carcinoma,” and “9”...

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June 22, 2011
General / Provider News

HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities

 

Beware of CPT® and Medicare differences when counting HPI elements.

Not accurately accounting for the history of presentillness (HPI) documented by your oncologist could result in missing appropriate opportunities to report level 4 or 5 E/M visits. Ensure you’re not missing higher paying possibilities by reviewing this guide to capturing HPI elements.

Brush Up on What Qualifies as an HPI Element

HPI is one of the three parts comprising an outpatient E/M history. It describes the patient’s present illness or problem, from the first sign/symptom to the current status, and typically drives a provider’s decisions about the physical examination and treatment. “The information gathered during the physical exam (PE) portion of a patient’s evaluation often only shows a very limited picture of the patient’s problem. However, speaking with a patient and gathering the history of the patient’s problem” can help fill out the picture, explains Amanda S. Stoltman, CCS-P, compliance coder at Urology Associates in Muncie, Ind.

 Start counting:

HPI also will often determine the level of service you’ll report. You’ll count the HPI elements to help you determine which level of service you can report. There are seven or eight HPI elements, depending on which source you are following. For Medicare, the eight elements are as follows: 

  • Location
  • Quality
  • Severity
  • Duration
  • Timing
  • Context
  • Modifying factors
  • Associated signs and symptoms.

Medicare includes the above list in both the 1995 and 1997 E/M Documentation Guidelines, available at www.cms.gov/MLNEdWebGuide/25_EMDOC.asp.

In contrast: CPT® lists only seven HPI elements in the E/M Services Guidelines, with duration not making the list. Therefore, for Medicare and payers following its guidelines, you should consider duration and timing separately. With payers that follow AMA rules, however, be aware that they don’t consider duration and timing to be two separate elements. Rumor has it...

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June 22, 2011
Coding Challenge / General

Pick Up on PIN III’s Trail in Index

Question: I have a path report that says “PIN III.” My problem is that the report also says “carcinoma was not identified,” so I’m confused about what to report. Which ICD-9 code is best?  Answer: With a diagnosis of PIN III, you should repo...

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June 22, 2011
Coder's Cranium / General / Hot Coding Topics

CMS Proposes New Glaucoma, Skin Cancer, Dementia Codes

Many new codes abound in final update to proposed ICD-9-CM code set.

 If you’ve felt that your skin cancer diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final. The list of ICD-9 changes was recently posted to the CMS Website, and includes the final full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, CMS will only add new ICD- 9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10.

Seek Out Skin Cancer Changes

You’ll find a significant expansion to the 173.x (Other malignant neoplasm of skin) categories, including changes to 173.0x (…Skin of lip), 173.1x (Eyelid, including canthus), 173.2x (Skin of ear and external auditory canal), 173.3x (Skin of other and unspecified parts of face), 173.4x (Scalp and skin of neck), 173.5x (Skin of trunk, except scrotum), 173.6x (Skin of upper limb, including shoulder), 173.7x (Skin of lower limb, including hip), 173.8x (Other specified sites of skin), and 173.9x (Skin, site unspecified).

Among these changes, for example, you’ll find the following new codes to delineate various types of skin cancers:

  • 173.60 —Unspecified malignant neoplasm of skin of upper limb, including shoulder
  • 173.61 — Basal cell carcinoma of skin of upper limb, including shoulder
  • 173.62 — Squamous cell carcinoma of skin of upper limb, including shoulder
  • 173.69 — Other specified malignant neoplasm of skin of upper limb, including shoulder.

 The changes in the other skin cancer categories referenced above follow this pattern, with the fifth digit of “0” referring to an unspecified malignant neoplasm, “1” denoting a basal cell cancer, “2” referring to a squamous cell carcinoma,” and “9” describing another...

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June 22, 2011