Improper coding of MS-DRG 813 (coagulation disorders), reporting an extensive operating room procedure unrelated to principal diagnosis (MS-DRGs 981,982,983, formerly DRG 468), and reporting the wrong diagnosis code or wrong principal diagnosis code for human immunodeficiency virus (HIV) disease...Read More »
Hospitals can start experimenting with how new ICD-10-CM/PCS codes will translate to MS-DRGs since CMS released its MS-DRG Version 28 Definitions Manual. ICD-10 is expected to map similarly to ICD-9; meaning when coders...Read More »
Since the inception of the permanent recovery audit contractor (RAC) program, government auditors have identified claims errors in excess of $350—$313.2 million of which were identified as overpayments and recouped by the government. ...Read More »
In response to President Barack Obama’s January 18 executive order aimed at reducing federal regulatory burdens, the American Medical Association (AMA) conducted a survey of its members seeking their input on the issue. More than 2,000 physicians responded. Of these, three out of five of named...Read More »
Hospital acquired conditions (HAC): The phrase seems simple enough to understand. These are conditions one acquires while in the hospital, right? Like most phrases included in the healthcare vernacular, however, discussion of HAC contains various levels of detail that can be difficult to...Read More »
The Centers for Disease Control (CDC) in March posted new 2011 guidelines for ICD-10-CM. There are relatively few changes to conventions, general coding guidelines, and chapter specific guidelines. Adjustments are easy to spot since...Read More »
Highlights from Coding Clinic, Third and Fourth Quarters 2010, include:
When a primary lung cancer metastasizes into another lobe of the lung, the second lesion should receive an additional code as a metastasis—not as a primary lesion. However, coders cannot