ICD-10-CM 2018: Succeed at Heart Failure Coding With This New Note Walk-Through

Thu, Aug 31, 2017


heart failure coding

We’re in the home stretch for ICD-10-CM 2018 prep, with about a month to go. We’ve covered the Official Guidelines, but you need to review the new instructions in the code set that come with code revisions, too. Case in point: Let’s take a closer look at the notes you’ll find with the updated diagnosis codes for heart failure (HF).

Size Up Systolic Additions

Inclusion terms: Existing subcategory I50.2- (Systolic (congestive) heart …

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Part 2: What Does the MPFS Proposed Rule Reveal About CPT® 2018?

Tue, Aug 29, 2017


2018 updates

Welcome to Part 2 of our look at what we can expect in CPT® 2018 based on what’s discussed in the Medicare Physician Fee Schedule 2018 Proposed Rule. Be sure to read Part 1 to get the complete picture. These are proposed codes, so of course keep checking back for in-depth updates once we start posting about the finalized 2018 code set.

Nervous System

Two proposed codes (64xxx) will apply to nerve repair with a nerve allograft. The first code is for the first strand, and you’ll report the second code for separate reporting of each additional strand.


Chest X-rays

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Part 1: What Does the MPFS Proposed Rule Reveal About CPT® 2018?

Sun, Aug 27, 2017

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2018 updates

When the Medicare Physician Fee Schedule Proposed Rule comes out, it includes discussions of how to value new codes, and it’s fun to look for insights into the procedure codes that will be coming our way. Let’s take a quick tour of what’s expected for CPT® 2018 based on what’s in the pages of the MPFS proposed rule.

Note: The proposed codes mentioned, such as 32xxx, are placeholder codes like the ones AMA and CMS use to suggest where the code will be in the code set if the code is finalized.


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Pair These ICD-10 2018 Official Guideline Updates With Their Code Set Counterparts

Fri, Aug 18, 2017


ICD-10 Official Guidelines

The ICD-10-CM 2018 Official Guidelines are out and ready for review. When you check through the new OGs for changes, take special note of these updates that line up with 2018 code set revisions.

Look at Level to Choose ‘In Remission’ Code

When you start to apply new codes for substance abuse in remission (you’ll find them in categories F10-F19), keep in mind this new paragraph in Section I.C.5.b.1:

Mild substance use disorders in early or sustained remission are classified to the appropriate codes for substance abuse in remission, and …

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ICD-10 2018: This Is Why Documenting Site Matters for Undescended-Testicle Coding

Tue, Aug 15, 2017


document location for more accurate coding

Our initial overview of ICD-10-CM 2018 looked at specialties with a large number of changes. But there are plenty of important changes coming Oct. 1, 2017, that didn’t fit into that quick analysis. Case in point: Urology has some interesting new codes that will be important for anyone who reports services related to congenital undescended testicles.

Does Your Documentation Have What It Takes?

The new codes fit into the existing subcategories of Q53.1- (Undescended testicle, unilateral) and Q53.2- (Undescended testicle, bilateral). To ensure accurate …

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Catch Up on the Latest HCPCS 2017 Updates for Ob-Gyn

Tue, Aug 8, 2017


ob gyn practice

In “Learn the ABCs (and Zs) of IUD Coding” we covered HCPCS codes available for the supply of the IUD. But coding is ever-changing, and there’s a new option as of July 1 for Kyleena®. Check out that new option and other HCPCS changes effective July 1 relevant to ob-gyn.

Tip: Want to see all the changes? Try the CMS HCPCS Quarterly Update page.

Start With Kyleena IUD

As of July 1, you have this new code for the supply of Kyleena IUD:

  • Q9984, …
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Add ICD-10-CM Accuracy to Your Repeat Pap Smear Claims

Fri, Jul 28, 2017

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Right about now it feels like all eyes are on ICD-10-CM 2018 (and there are plenty of changes to deal with). But we’ve got to be sure codes for our current claims are accurate, too. Today let’s get back to basics with a look at how to handle diagnosis coding for repeat Pap smears.

Zero In on R87.61- Subcategory

When the provider repeats a Pap smear because of an inadequate sample or abnormal results, you’ll report a code from R87.61- (Abnormal cytological findings …

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Ups and Downs, MACRA Modifiers, and E/M DGs in MPFS 2018 Proposed Rule

Tue, Jul 25, 2017


EHR documentation

Part 3 of our proposed rule extravaganza is about the Medicare Physician Fee Schedule (MPFS) 2018 proposed rule. (Part 1 was QPP and Part 2 was OPPS). Let’s get down to business, checking out some highlights explained in recent issues of Medicare Compliance and Reimbursement.

Plusses and Minuses

The proposed 2018 conversion factor is 35.99, up 0.1 from the 2017 CF of about 35.89. CMS estimates the overall update to payments is +0.31 percent. That’s the 0.5 percent increase established under …

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4 Things to Watch From the OPPS 2018 Proposed Rule

Fri, Jul 21, 2017


outpatient hospital

We’re back for another installment of “what does 2018 (maybe) have in store”? We just covered the QPP proposed rule, and now we’ll take a look at the 2018 hospital outpatient prospective payment system (OPPS) proposed rule. CMS expects an overall 2 percent payment increase in 2018 (except for the changes mentioned in question 3 below). What has people talking?

1. Are Joint Replacements Moving to Outpatient?

The proposed rule takes total knee replacement off the inpatient-only list, opening the …

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