Nasal cavity polyp also goes by the term “choanal” and “nasopharyngeal.” If the otolaryngologist performed a removal of a middle turbinate endoscopically, you would report it with CPT 31240 — subsequently linking this procedure to a diagnosis...
Here is what you should check in your physician’s documentation. As the conversion takes place from ICD-9 to ICD-10 in 2013, you will not be treating the codes in a way you always did. Often, you will have more options that may need tweaking the way ...
When ICD-9 becomes ICD-10 in 2013, you will not always have a simple crosswalk relationship between old codes and the new ones. Often, you’ll have more options that may require tweaking the way you document services and a coder reports it. Check out the following examples of how ICD-10 will change your coding options when the calendar turns to Oct. 1, 2013.
Celebrate Sinusitis Codes’ One-to-One Relationship for ICD-10
When your physician treats a patient for sinusitis, you should report the appropriate sinusitis code for sinus membrane lining inflammation. Use 461.x for acute sinusitis. For chronic sinusitis — frequent or persistent infections lasting more than three months — assign 473.x.
For both acute and chronic conditions, you’ll choose the fourth digit code based on where the sinusitis occurs. For example, for ethmoidal chronic sinusitis, you should report (473.2, Chronic sinusitis; ethmoidal). Your otolaryngologist will most likely prescribe a decongestant, pain reliever or antibiotics to treat sinusitis.
ICD-10 difference: Good news. These sinusitis options have a one-to-one match with upcoming ICD-10 codes. For acute sinusitis diagnoses, you’ll look at the J01.-0 codes. For instance, 461.0 (Acute maxillary sinusitis) translates to J01.00 (Acute maxillary sinusitis, unspecified). Code 461.1 (Acute frontal sinusitis) maps directly to J01.10 (Acute frontal sinusitis). Notice how the definitions are mostly identical. Like ICD-9, the fourth digit changes to specify location.
For chronic sinusitis diagnoses, you’ll look to the J32.- codes. For instance, in the example above, 473.2 maps direction to J32.2 (Chronic ethmoidal sinusitis). Again, this is a direct one-to-one ratio with identical definitions. Like ICD-9, the fourth digit changes to specify location.
Physician documentation: Currently, the physician should pinpoint the location of the sinusitis. This won’t change in 2013.
However, you’ll scrap the 461.x and 473.x options and turn to J01.-0 and J32.- in your ICD-10...
When ICD-9 becomes ICD-10 in 2013, you’ll need to get familiar with different sections in the new diagnosis code system, even if the condition you’re reporting has a simple one-to-one crosswalk. When your surgeon performs a hiatal hernia repair, yo...
When ICD-9 becomes ICD-10 in October 2013, the diagnosis codes you’re accustomed to reporting will no longer exist. Many diagnosis codes will include more details than their current counterparts, and some sub-codes of the same family will even move t...
New sprain codes are both described as “unspecified.” Find out what clues to look for. You can use new ultrasound test codes 76881 (Ultrasound, extremity, nonvascular, real-time with image documentation; complete) and 76882 (Ultrasound, extremity, ...
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...
600 coders, physicians, and office managers gathered in Orlando, Fla. for one and a half jam-packed days of education, networking, and shopping at the December 2011 Coding Update and Reimbursement Conference. Coders’ biggest struggle was absorbing all the information – and not overdoing the holiday buying. Experts offered the inside scoop on medical coding changes for 2011 and beyond. Here are my top picks:
This...
Get used to using letters in your diagnosis coding. Take a look at some of the ways your urology diagnosis coding will change in 2013 by reviewing this chart of some common diagnoses you see in your urology practice. This rundown, based on the ICD-10 2...
Say goodbye to form 4010A1 for ICD codes as well, starting in 2012.
Dig into your claim forms now to ensure that the beneficiary’s information is accurate to the letter, or you’ll face scores of denied claims on the new HIPAA 5010 forms.
Why it matters: CMS will deny claims on which the beneficiary’s name doesn’t perfectly match how it’s listed on his Medicare I.D. card when you begin using HIPAA 5010 form — the new Medicare universal claim form starting in 2012.
Include Jr. or Sr. Suffixes
“Whenever there is a name suffix, such as ‘Jr.’ or ‘Sr.’ abbreviations, etc., it must be included with the last name,” said Veronica Harshman of CMS’s Division of Medicare Billing Procedures during an April 28 Open Door Forum regarding the eligibility component of the HIPAA 5010 form.
You can include the suffix either with the patient’s last name or in the suffix field, specified CMS’s Chris Stahlecker during the call.
“The date of birth must also match exactly to what the Social Security Administration has on file,” Harshman said. CMS will use several new error codes on claims once the 5010 form goes into effect. “If you communicate with CMS through a third-party vendor (clearinghouse), it is strongly recommended that you discuss with them how these errors will be communicated to you and how these changes will impact you and your business,” Harshman advised.
Look for Production Systems Next Year
According to the HIPAA 5010 Final Rule, CMS will have a production 5010 system available as of Jan. 1, 2011, Harshman said.
The last day CMS will accept a 4010A1 form will be Dec. 31, 2011. As of Jan. 1, 2012, if you aren’t using the 5010 form, you’ll “lose the ability to receive eligibility data from Medicare,” Harshman said. In...
Plus: CMS has proposed freezing the ICD-9 codeset after next year.
If you were hoping that the Oct. 1, 2013 ICD-10 implementation date wasn’t set in stone, you are out of luck. That’s the word from CMS during a June 15 CMS Open Door Forum entitled “ICD-10 Implementation in a 5010 Environment.”
“There will be no delays on this implementation period, and no grace period,” said Pat Brooks, RHIA, with CMS’s Hospital and Ambulatory Policy Group, during the call. “A number of you have contacted us about rumors you’ve heard about postponement of that date or changes to that date, but I can assure you that that is a firm implementation date,” she stressed.
Brooks indicated that the rumor about a potential delay in the implementation date continues to persist throughout the physician community, and recommended that practice managers alert their physicians to the fact that that the rumor is untrue.
The Oct. 1, 2013 date will be in effect for both inpatient and outpatient services. Keep in mind that the ICD-10 implementation will have no impact on CPT and HCPCS coding, Brooks said. You will still continue to bill your CPT and HCPCS procedure codes as before.
You’ll Find Nearly 55,000 Additional Codes
Currently, CMS publishes about 14,000 ICD-9 codes, but there are over 69,000 ICD-10 codes. The additional codes will allow you to provide greater detail in describing diagnoses and procedures, Brooks said.
If you’re wondering which specific codes ICD-10 includes for your specialty, you can check out the entire 2010 ICD-10 codeset, which CMS has posted on its Web site. “Later this year, we’ll be posting the 2011 update,” Brooks said during the call.
@ For more details on CMS’ upcoming plans, subscribe to Part B Insider (Editor: Torrey Kim, CPC).
Sign...
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...
Relying on the physician’s encounter form could be a big mistake.
Question: I used 491.9 to report a patient’s bronchitis, but the payer denied my claim and requested additional information. What was wrong?
Vermont Subscriber
Answer: Your claim may have...
Bonus: Get exposure to ICD-10 coding equivalents.
Question: A mentally-challenged patient who delivered at home was admitted to the hospital for postpartum care. The patient delivered the placenta at home, and once admitted, she had no complications, but the ob-gyn…
Check out these ICD-10 ob-gyn diagnosis coding equivalents.
Question: A patient presented for an initial OB visit. Another clinic confirmed her pregnancy, but she has never received prenatal care. The patient got her usual initial OB service (i.e. lab orders),…
Do N95.0 and N95.2 look foreign? Get your ob-gyn ICD-10 equivalents now. Spare yourself denial hot flashes by taking this three-part postmenopausal abnormality scenario challenge. Fill In These Blanks Using Your ICD-9 Book Question 1: Your ob-gyn sees a post menopausal patient with an inflamed vagina because the tissues are thinning and shrinking. The ob-gyn notes decreased vaginal [...] Related articles: