Tip of the Week: Coding Acute Myocardial Infarction
by Lori Becks, RHIA - January 11, 2012
Coding acute myocardial infarction (AMI) in category 410 requires documentation of the site and the episode of care. The fourth digit reports the site, while the fifth digit reports the episode of care. Report a code from subcategory 410.9x only when an unspecified term, such as ‘myocardial infarction’, ‘acute MI’, ‘coronary occlusion’, or ‘STEMI’ is documented without a site. When the physician documents an acute MI as ‘nontransmural’ or ‘subendocardial’ with the site, report the appropriate code from category 410.7x. If the patient has a documented AMI at separate sites for the same admission, use multiple codes from category 410.
ICD-10-PCS Root Operations – Extraction, Destruction, Detachment
by Lauri Gray, CPC, RHIT - January 4, 2012
Last month in the root operation series we discussed excision and resection which are two of the five root operations that are performed for the purpose of taking out or eliminating all or a portion of a body part. This article covers the remaining three operations in this category – extraction, destruction, and detachment. All five root operations are summarized in the table below.
ICD-10 Corner: Root Operations
by Lauri Gray, CPC, RHIT - January 4, 2012
When coding using ICD-10-PCS, common terminology in the physician documentation cannot necessarily be used to assign the correct root operation. For example, the physician documentation may use the term removal to describe a number of different root operations, including an excision, resection, or extraction. If the procedure involves removal of tissue, a body part or an organ without replacement, the coder must first determine from the documentation whether the removal was performed by cutting in which case the procedure is an excision or resection or by the use of force in which case the procedure is an extraction. If the removal was performed by cutting, the coder must determine whether all or part of the body part was removed. Removal of all of the body part is coded to resection while removal of only part of the body part is coded to excision.
December Hot Topics Contest
by Elena Wellard - January 3, 2012
Contexo Media extends our congratulations to Kim Budde, our November Hot Topics Contest winner. She will receive a Coding Diva t-shirt. We had a wonderful time with this contest and want to thank all the participants.
Would you like to win a Coding Diva t-shirt?
To enter to win, simply leave a comment listing the Hot Topic from each of our four December issues. The first person to submit the correct response will win the t-shirt. Please don’t forget to add your e-mail address so we can notify you if you are the winner.
Hint: The Hot Topic appears each week in the header of Coder’s Voice.
Good Luck!
December Quiz Recap
by Elena Wellard - January 3, 2012
We understand that you are busy and might not have time to read Coder’s Voice every Thursday. That’s why we’ve put together a recap of Coder’s Quizzes for you. Take a quick look to see what you may have missed.
Do you think the AMA will succeed in fighting ICD-10 implementation?
Yes – 15%
No – 76%
I do not know – 9%
Tip of the Week: Closed Hip Reduction
by Lori Becks, RHIA - January 2, 2012
A closed hip reduction performed on a dislocated hip that has previously undergone total hip replacement requires that code 996.42 Dislocation of a prosthetic joint, be submitted as the appropriate diagnosis code and not a code from subcategory 835.0x for closed dislocation of hip. Closed reduction performed in this case can be reported with either CPT code 27265 Closed treatment of post hip arthroplasty dislocation; without anesthesia or 27266 Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia.
CMS Coverage of Obesity Screening
by Bonnie Schreck, CCS, CPC, CPC-H, CCS-P, COBGC - December 21, 2011
On November 29, 2011, a final coverage decision memorandum was passed by the Center for Medicare and Medicaid Services (CMS) for intensive behavioral therapy for obesity. These services have been deemed reasonable and necessary for the prevention or early detection of illness and/or disability and are appropriate for individuals entitled to benefits under Part A or enrolled under Part B.
CMS specified in the decision memo that it will cover:
- One face-to-face visit every week for the first month in the primary care setting;
- One face-to-face visit every other week for months 2-6;
- One face-to-face visit every month for months 7-12, if the Medicare beneficiary meets the 3kg (6.7 lbs) weight loss requirement.
Tip of the Week: V Codes
by Lori Becks, RHIA - December 21, 2011
The V codes in category V85 for body mass index can only be reported as secondary diagnoses; however, the assignment of BMI can be based on documentation from a clinician involved in the patient’s care, such as a dietician, and need not necessarily come from the patient’s physician. The associated main diagnosis, whether overweight, obesity, or morbid obesity must be established by the patient’s physician or other legally qualified healthcare practitioner.
ICD-10 Corner: Overweight and Obesity Codes
by Lauri Gray, CPC, RHIT - December 21, 2011
In ICD-10-CM, overweight and obesity codes are listed in category E66. Overweight is reported with code E66.3. Obesity may be due to excess calories (E66.0-), drug-induced (E66.1), with alveolar hypoventilation (E66.2), due to other specified causes (E66.8) or unspecified (E66.9). Obesity due to excess calories is further differentiated as severe/morbid (E66.01) or other (E66.09). For drug-induced obesity, the drug is coded first from categories T36-T50. If the body mass index (BMI) is known, it is reported with an additional code from category Z68.
Coding for Screening Laboratory Tests
by Roxanne Thames CPC, CEMC - December 14, 2011
Often we have patients who identify to us that they have coverage for “screening blood work.” This can pose a dilemma for coders and billers due to the coding rules related to reporting screening diagnosis codes. Here are a few things to consider when choosing the code to be used to bill for labs being drawn for a well adult visit.
Has this patient been previously diagnosed with a medical condition that would require you to perform this lab test? If your answer is yes, then this does not qualify as screening blood work. Use the code associated with the diagnosis (e.g., hyperlipidemia or diabetes or benign essential hypertension) and not a screening code as the primary diagnosis code for the lab tests.
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