• Understanding Important Facts Around the ACA and Potential Replacement or Revisions
  • Cultural Competency Series: Transgendered Patients
  • HMO, PPO, EPO, Oh My!
  • World AIDS Day
  • World Diabetes Day is November 14th

New Guidance on Diagnoses, Clinical Evidence, and Abnormal Findings in ICD-10-CM Effective DOS Oct. 1, 2016

Over the years I have heard medical coders question the provider’s diagnosis. For example, someone might say, but how can you say the patient has CKD Stage III with that GFR lab? Or another might state, how can you say the patient has Protein Calorie Malnutrition, since the labs are all normal? There are many of these examples. We should always maintain a level of respect for providers and accept…

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New Guidance on the word “with” in ICD-10-CM Effective DOS 10/1/2016

Under new guidance from ICD-10-CM, the term “with,” when used in the Alphabetical Index, Tabular, or instructional notes, was only used by ICD-10-CM authors when two conditions are normally associated with one another clinically. This means that the provider does not need to demonstrate a cause and effect relationship whenever the word “with” is found in ICD-10-CM as a descriptor in the Alphabetical Index, Tabular, or instructional notes. A. Conventions for…

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Clarity on Laterality for ICD-10-CM Effective Oct. 1, 2016

New guidance is offered in the new ICD-10-CM for 2017 that is effective October 1, 2016 on laterality. There have been some questions on which side to assign codes when one side vs. another is being treated or addressed or repaired. These new guideline clarifications can be found below in blue: B. General Coding Guidelines 13. Laterality When a patient has a bilateral condition and each side is treated during…

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New NIH Stroke Scale Codes in ICD-10-CM Effective DOS Oct 1 2016

There is an updated section of ICD-10-CM effective October 1, 2016 regarding the newly added NIH Stroke Scale (NIHSS) codes that have now been added this year to ICD-10-CM. The NIHSS can be used as a clinical stroke assessment tool to evaluate and document neurological status in acute stroke patients. The stroke scale is valid for predicting lesion size and can serve as a measure of stroke severity. The NIHSS has been…

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Managing People Near and Far

I frequently hear people desiring a job as a manager or supervisor, while simultaneously hearing other people complain about their managers. Managerial positions are attractive for both the respect they often command as well as the higher salaries that are typically associated with them. Some organizations have policies and procedures for selection of managers, while others simply interview what they believe to be “good candidates.”  What makes a “good candidate”…

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FAQ’s on Risk Adjustment

FAQ’s on Risk Adjustment Brian Boyce, BSHS, CPC, CPC-I, CRC, CTPRP Risk adjustment is a new payment methodology that is prospective in nature; meaning that instead of paying for costs after services are rendered, we are estimating costs in future years based on what we know to be true of the patient in the recent and current years. This article will cover the basics of risk adjustment, where to find…

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