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Latest News


CODING TIP: CHRONIC SUBSEGMENTAL PULMONARY EMBOLI – ONE CODE OR TWO?

Aug 27, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

With the creation and implementation of ICD-10-CM, multiple codes are available
to describe the type of pulmonary emboli that occur.





CODING TIP: HYPERCOAGULABLE STATES

Aug 20, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

Hypercoagulable states are blood disorders that increase the risk of deep vein
thrombosis or embolic disease. The state is either inherited or acquired. About
80% of patients with blood clots have been found to have either an inherited or
acquired clotting disorder. These blood clots can be lethal and some require
life-long therapy. Hypercoagulable state is also known as thrombophilia.





CODING TIP: DO’S AND DON’TS OF REPORTING ENCEPHALOPATHY

Aug 16, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

Encephalopathy is a general term and means brain disease, brain damage or
malfunction. Physicians often use encephalopathy and altered mental status
interchangeably. When coders see this documentation in the healthcare records,
they typically need to query the physician for clarification of the diagnosis.





CODING TIP: SPINAL DECOMPRESSION CODING IN ICD-10-PCS

Aug 10, 2021 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

Spinal procedure coding can be daunting for coders. The spine itself can be
quite complicated anatomically and the procedures done to address spinal
conditions can be even more complicated!





CODING TIP: SNEAK PEEK AT FY2022 ICD-10-PCS PROCEDURE ADDITIONS AND CHANGES

Jul 22, 2021 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

In June CMS released the final ICD-10-PCS codes for FY2022, which begins October
1, 2021. We are giving you a sneak peek at the changes. HIA will have a full
educational module on these changes available later this summer.





CODING TIP: SNEAK PEEK AT FY2022 PROPOSED DRG CHANGES

Jun 14, 2021 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

CMS released the IPPS proposed rule on 4/27/21 outlining the proposed changes to
the Inpatient Prospective Payment System for FY2022, which begins October 1,
2021. Later this year, sometime in August, CMS will release the Final Rule.
Currently CMS is reviewing responses to their proposed rule and will address
them in the final rule.





WHAT TO CONSIDER BEFORE YOUR NEXT CODING AUDIT

May 19, 2021 | Coding Review, Coding Support, Education

A medical coding audit is a process that includes internal or external reviews
of medical coding and billing accuracy, procedures or policies in place, and any
other component that affects the medical record documentation. Medical coding
audits…





CODING TIP: ANTICOAGULATION AND ANTIPLATELET THERAPY

May 6, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

Anticoagulants and antiplatelets are used for the prevention and treatment of
blood clots that occur in blood vessels.  Oftentimes, anticoagulants and
antiplatelets are referred to as “blood thinners,” but they don’t actually thin
the blood at all. These drugs slow down the body’s process of making clots.
Their main function is to keep the patient’s blood from clotting or turning into
solid clumps of cells. These drugs do this by interfering with either fibrin or
platelets in the blood.





CODING TIP: CAROTID ARTERY DISEASE

Apr 29, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

Carotid artery disease is a vague category that can incorporate many different
carotid artery issues. Some physicians may feel that they are being clear the
patient has plaque, stenosis, or occlusion of the artery, but in ICD-10-CM the
specificity must be included in the documentation.





NATIONAL SUPERHERO DAY: ICD-10 CODES FOR SUPERHEROES

Apr 27, 2021 | Coding Review, Coding Support, Education

10 ICD-10 Codes for Superheroes. Superman: T78.2XXA Anaphylactic reaction;
substance: kryptonite. Batman: F44.81 Dissociative identity disorder. Robin:
F60.7 dependent personality. The Hulk: L30.4 Erythema intertrigo. Wonder Woman:
T24.032A Burn of unspecified degree of left lower leg. Black Panther S93.401A
Sprain…





OVERVIEW OF THE 2021 E/M GUIDELINE CODING CHANGES

Apr 19, 2021 | Coding Review, Coding Support, Education

Practices have not seen many revisions to the Evaluation and Management (E/M)
office / outpatient visit guidelines in three decades – until now. As of January
1, there are new E/M coding guidelines. We’ll get to those in a bit, but first
let’s look at why they changed.





CODING TIP: UNDERSTANDING AND REPORTING PSEUDOSEIZURES

Apr 15, 2021 | Coding Tips, Education, ICD-10, Kim Carrier

Pseudoseizures are a form of non-epileptic seizure. These are difficult to
diagnose and oftentimes extremely difficult for the patient to comprehend. The
term “pseudoseizures” is an older term that is still used today to describe
psychogenic nonepileptic seizures (PNES).





CODING TIP: CODING BOWEL OBSTRUCTION IN ICD-10-CM

Apr 8, 2021 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

With the implementation of ICD-10-CM came different codes and coding rules for
many diagnoses. One of these is the coding of bowel obstruction when the patient
presents for this condition that is caused by another condition.





PART 5: NEW 2021 CPT CODES | MODIFIERS, CATEGORY III, EVALUATION AND MANAGEMENT,
ETC.

Feb 17, 2021 | 2021 New CPT Codes, CPT, Education, Patricia Maccariella-Hafey,
Series

This is Part 5 of a five part series on the new 2021 CPT codes. For the
remaining areas we will just briefly summarize the section. Due to the intricate
nature of these sections in CPT, it is recommended that the coder read the
entire section notes associated with the new codes.





PART 4: NEW 2021 CPT CODES | URINARY, NERVOUS, OCULAR AND AUDITORY SYSTEMS

Feb 10, 2021 | 2021 New CPT Codes, CPT, Education, Patricia Maccariella-Hafey,
Series

This is Part 4 of a five part series on the new 2021 CPT codes. In this series
we will explore the CPT changes in the urinary, nervous, ocular and auditory
systems. There are 2 new urinary/male reproductive system codes with no
revisions or deletions; 3 new female reproductive codes with 2 deletions, 0 new
with 4 deleted nervous system codes with 5 revisions; 5 new eye category III
codes; and finally a 2 new auditory codes with one deletion.





PART 3: NEW 2021 CPT CODES | CARDIOVASCULAR SYSTEM

Feb 2, 2021 | 2021 New CPT Codes, CPT, Education, Patricia Maccariella-Hafey,
Series

This is Part 3 of a five part series on the new 2021 CPT codes. In this series
we will explore the cardiovascular system CPT changes. There are 5 new
cardiovascular CPT codes added with 0 deletions and 4 revisions.





PART 2: NEW 2021 CPT CODES | MUSCULOSKELETAL AND RESPIRATORY SYSTEMS

Jan 27, 2021 | 2021 New CPT Codes, CPT, Education, Patricia Maccariella-Hafey,
Series

This is Part 2 of a five part series on the new 2021 CPT codes. In this series
we will explore the CPT changes for FY2021 and include some examples to help the
coder understand the new codes. There are 0 new musculoskeletal CPT codes added
with 0 deletions and 2 major revisions along with an extensive update to
arthroscopic loose body removal requirements. For the respiratory system, there
were 2 new codes, one code deletion and no revisions.





PART 1: NEW 2021 CPT CODES | INTEGUMENTARY SYSTEM

Jan 19, 2021 | 2021 New CPT Codes, CPT, Education, Patricia Maccariella-Hafey,
Series

This is Part 1 of a five part series on the new 2021 CPT codes.  In this series
we will explore the CPT changes for FY2021 and include examples to help the
coder understand the new codes.  For 2021 in general, there were 199 new CPT
codes added, 54 deleted and 69 revised.





2020: YEAR IN REVIEW | CODING EDUCATION

Dec 29, 2020 | Coding Review, Coding Support, Coding Tips, Coronavirus,
COVID-19, CPT, Education, ICD-10, Outpatient, Patricia Maccariella-Hafey

In January, new CPT codes were released.  There were 248 new CPT codes added, 71
deleted and 75 revised.  Most of the surgery section changes were in the
musculoskeletal and cardiovascular subsections. These included procedures such
as skin grafting, breast biopsies, deep drug delivery systems, tricuspid valve
repairs, aortic grafts and repair of iliac artery.





CODING TIP: NEW COVID-19 CODES EFFECTIVE JANUARY 1, 2021

Dec 2, 2020 | Coding Tips, Coronavirus, COVID-19, Education, ICD-10, Patricia
Maccariella-Hafey

We have seen many updates and changes to COVID-19 (SARS-CoV-2) since the
pandemic started. On January 1, 2021 we will see even more changes as outlined
in this post. Also the CMS MS-DRG grouper will be updated to version 38.1 to
accommodate the changes.





NEW TECHNOLOGY ADD-ON PAYMENTS (NTAP) FOR FY2021 – PART 4

Oct 28, 2020 | Coding Tips, Education, ICD-10, IPPS, IPPS 2021, Patricia
Maccariella-Hafey

In the previous three parts of this four-part series, we discussed the new
ICD-10-CM diagnosis code changes, ICD-10-PCS procedure code changes and FY2021
IPPS changes. In this last Part 4 of the series, we will review the NTAP
procedure codes and reimbursement add-on payments for FY2021.





NEW ICD CODES AND IPPS CHANGES FOR FY2021 (ICD-10-CM DIAGNOSES CHANGES) – PART 3

Oct 26, 2020 | Coding Tips, Education, ICD-10, IPPS, IPPS 2021, Patricia
Maccariella-Hafey

In the previous two parts of this four part series, we discussed the new
ICD-10-CM diagnosis code changes and ICD-10-PC procedure code changes. In this
session we will review the major IPPS changes for FY2021.





NEW ICD CODES AND IPPS CHANGES FOR FY2021 (ICD-10-CM DIAGNOSES CHANGES) – PART 2

Oct 23, 2020 | Coding Tips, Education, ICD-10, IPPS, IPPS 2021, Patricia
Maccariella-Hafey

This is Part 2 of a 4 part series on the FY2021 ICD-10 Code and IPPS changes. In
this part, the ICD-10-PCS procedure codes are presented. For FY2021 ICD-10-PCS 
there are 78,115 total codes  (FY2020 total was 77,571); 556 new codes  (734 new
last year in FY2020)…





CODING TIP: REPORTING “FLASH” PULMONARY EDEMA

Oct 5, 2020 | Coding Tips, Education, ICD-10, Kim Carrier

Acute pulmonary edema is the rapid accumulation of fluid within the tissue and
space around the air sacs of the lung (lung interstitium). When this fluid
collects in the air sacs in the lungs it is difficult to breathe. Acute
pulmonary edema occurs suddenly and is life threatening.





CLIENT S: $556 INCREASE/RECORD REVIEWED

Oct 1, 2020 | Coding Review, Education

“Client S” is a small, not-for-profit, 40 bed micro-hospital in the Southeast.
HIA performed a 65-record review this year for Client S and found an opportunity
with 15 of them. 9 had an increased reimbursement with a total of $43,228 found.





CODING TIP: GLASGOW COMA SCALE CODING OCG UPDATE FOR FY2021

Sep 29, 2020 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

The coma scale codes (R40.2-) can be used in conjunction with traumatic brain
injury codes, acute cerebrovascular disease or sequelae of cerebrovascular
disease codes. These codes are primarily for use by trauma registries, but they
may be used in any setting where this information is collected. The coma scale
may also be used to assess the status of the central nervous system for other
non-trauma conditions, such as monitoring patients in the intensive care unit
regardless of medical condition.





CODING TIP: CARDIAC ARREST AND CARDIAC SHOCK

Sep 21, 2020 | Coding Tips, Education, ICD-10, Patricia Maccariella-Hafey

In the past, there had been an Excludes1 note at I46.- Cardiac arrest that
excluded R57.0, Cardiac shock. HIA had also received a letter from AHA on a case
in the past that had stated that only I46.- Cardiac arrest would be coded if
both were documented. In addition, the Third Quarter Coding Clinic page 26 had a
similar case that asked if both could be coded, and AHA had instructed that only
I46.9, cardiac arrest, cause unspecified would be coded if both were documented
and that the CDC would be looking at possible revision to the Excludes1 note.





CLIENT X: LET’S TALK NUMBERS

Sep 15, 2020 | Coding Review, Education

A higher CMI corresponds to increased consumption of resources and increased
cost of patient care, resulting in increased reimbursement to the facility from
government and private payers, like CMS. We know that documentation directly
impacts coding.





CODING TIP: ENDARTERECTOMY DURING CORONARY ARTERY BYPASS

Sep 10, 2020 | Coding Tips, Education, ICD-10, Kim Carrier

Lately we have seen several cases where the endarterectomy was assigned along
with the coronary artery bypass (CABG) procedure when being performed on the
same vessel to facilitate the CABG. A coronary artery endarterectomy is not
always performed during a CABG procedure, so when it is performed it becomes
confusing as to whether to code it separately or not.





2021 E/M Guideline Changes

The 2021 E/M Guidelines have been in place since January 1, 2021. How are you
doing so far? The biggest change for providers is to decide whether to use
Medical Decision Making (MDM) or Time.

LEARN MORE

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educator and internal auditor. HIA’s service is aimed at providing a reliable
resource to address all 3 important functions and more – all for one fixed
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 * Coding Tip: Chronic Subsegmental Pulmonary Emboli – One Code or Two? August
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 * Coding Tip: Hypercoagulable States August 20, 2021
 * Coding Tip: Do’s and Don’ts of Reporting Encephalopathy August 16, 2021
 * Coding Tip: Spinal Decompression Coding in ICD-10-PCS August 10, 2021
 * Coding Tip: Sneak Peek at FY2022 ICD-10-PCS Procedure Additions and Changes
   July 22, 2021

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