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Bill Dunbar and Associates - Revenue Growth Strategies to Medical Coding Professionals, Hospitals, and Practices throughout the US

Emergency Medicine

One of the greatest impacts on Emergency Departments' revenue capture is their familiarity with the differences between physician coding and facility coding. One utilizes an internal point system, while the other follows a clear set of Evaluation and Management guidelines.

Revised 2011 ICD-9 Updates

Revised 2011 ICD9 Code UpdatesOctober 1, 2010 is when the New and Revised ICD-9 2011 codes take effect. If you neglect to update your existing billing software with the new updates, it could delay claims which then could result in delayed payments. We hope that you’ll take advantage of these resources now to avoid any delay in your payment for services.

New 2011 ICD-9 Codes

In the “New” ICD category, there are several new codes that have been expanded from prior years. For example, there are six new codes in the Pneumonia and Influenza category (480-488). Three are related to the Avian influenza, while the remaining three are related to the Novel H1N1 influenza. There are eleven new “V-Codes” that refer to persons with potential health hazards related to personal and family history(V10-V19).88. In addition there are seven new codes relating to the Body Mass Index (BMI). The largest segment of new ICD codes is related to Multiple Gestation Placenta Status (V91) with a total of seventeen new codes.

Each year, BDA provides tools to assist physicians and organizations with the ICD-9 code changes. We’ve put together a Power Point presentation that goes over these new 2011 ICD9 changes for you. You can view the slideshow online, or download the Power Point and PDF by clicking on the play button on the image below. 2011 ICD9 New Code Updates2011 New ICD9 Code Updates Power PointICD-9-CM Guidelines, Conversion Table, and Addenda

From: New, Deleted, and Revised ICD-9-CM Codes – Summary Tables

The final addendum providing complete information on changes to the diagnosis part of ICD-9-CM is posted on CDC’s webpage at: www.cdc.gov/nchs/icd9.htm

  • 237.73 – Schwannomatosis
  • 237.79* – Other neurofibromatosis
  • 275.01 – Hereditary hemochromatosis
  • 275.02 – Hemochromatosis due to repeated red blood cell transfusions
  • 275.03 – Other hemochromatosis
  • 275.09 – Other disorders of iron metabolism
  • 276.61 – Transfusion associated circulatory overload
  • 276.69 – Other fluid overload
  • 278.03 – Obesity hypoventilation syndrome
  • 287.41 – Posttransfusion purpura
  • 287.49 – Other secondary thrombocytopenia
  • 315.35* – Childhood onset fluency disorder
  • 447.70 – Aortic ectasia, unspecified site
  • 447.71 – Thoracic aortic ectasia
  • 447.72 – Abdominal aortic ectasia
  • 447.73 – Thoracoabdominal aortic ectasia
  • 488.01* – Influenza due to identified avian influenza virus with pneumonia
  • 488.02* – Influenza due to identified avian influenza virus with other respiratory manifestations
  • 488.09* – Influenza due to identified avian influenza virus with other manifestations
  • 488.11* – Influenza due to identified novel H1N1 influenza virus with pneumonia
  • 488.12* – Influenza due to identified novel H1N1 influenza virus with other respiratory manifestations
  • 488.19* – Influenza due to identified novel H1N1 influenza virus with other manifestations
  • 560.32 – Fecal impaction
  • 724.03 – Spinal stenosis, lumbar region, with neurogenic claudication
  • 752.31 – Agenesis of uterus
  • 752.32 – Hypoplasia of uterus
  • 752.33 – Unicornuate uterus
  • 752.34 – Bicornuate uterus
  • 752.35 – Septate uterus
  • 752.36 – Arcuate uterus
  • 752.39 – Other anomalies of uterus
  • 752.43 – Cervical agenesis
  • 752.44 – Cervical duplication
  • 752.45 – Vaginal agenesis
  • 752.46 – Transverse vaginal septum
  • 752.47 – Longitudinal vaginal septum
  • 780.33 – Post traumatic seizures
  • 780.66 – Febrile nonhemolytic transfusion reaction
  • 784.52* – Fluency disorder in conditions classified elsewhere
  • 784.92 – Jaw pain
  • 786.30 – Hemoptysis, unspecified
  • 786.31 – Acute idiopathic pulmonary hemorrhage in infants [AIPHI]
  • 786.39 – Other hemoptysis
  • 787.60 – Full incontinence of feces
  • 787.61 – Incomplete defecation
  • 787.62 – Fecal smearing
  • 787.63 – Fecal urgency
  • 799.51 – Attention or concentration deficit
  • 799.52 – Cognitive communication deficit
  • 799.53 – Visuospatial deficit
  • 799.54 – Psychomotor deficit
  • 799.55 – Frontal lobe and executive function deficit
  • 799.59 – Other signs and symptoms involving cognition
  • 970.81 – Poisoning by cocaine
  • 970.89 – Poisoning by other central nervous system stimulants
  • 999.60 – ABO incompatibility reaction, unspecified
  • 999.61 – ABO incompatibility with hemolytic transfusion reaction not specified as acute or delayed
  • 999.62 – ABO incompatibility with acute hemolytic transfusion reaction
  • 999.63 – ABO incompatibility with delayed hemolytic transfusion reaction
  • 999.69 – Other ABO incompatibility reaction
  • 999.70 – Rh incompatibility reaction, unspecified
  • 999.71 – Rh incompatibility with hemolytic transfusion reaction not specified as acute or delayed
  • 999.72 – Rh incompatibility with acute hemolytic transfusion reaction
  • 999.73 – Rh incompatibility with delayed hemolytic transfusion reaction
  • 999.74 – Other Rh incompatibility reaction
  • 999.75 – Non-ABO incompatibility reaction, unspecified
  • 999.76 – Non-ABO incompatibility with hemolytic transfusion reaction not specified as acute or delayed
  • 999.77 – Non-ABO incompatibility with acute hemolytic transfusion reaction
  • 999.78 – Non-ABO incompatibility with delayed hemolytic transfusion reaction
  • 999.79 – Other non-ABO incompatibility reaction
  • 999.80 – Transfusion reaction, unspecified
  • 999.83 – Hemolytic transfusion reaction, incompatibility unspecified
  • 999.84 – Acute hemolytic transfusion reaction, incompatibility unspecified
  • 999.85 – Delayed hemolytic transfusion reaction, incompatibility unspecified
  • E000.2 – Volunteer activity
  • V11.4 – Personal history of combat and operational stress reaction
  • V13.23 – Personal history of vaginal dysplasia
  • V13.24 – Personal history of vulvar dysplasia
  • V13.62 – Personal history of other (corrected) congenital malformations of genitourinary system
  • V13.63 – Personal history of (corrected) congenital malformations of nervous system
  • V13.64 – Personal history of (corrected) congenital malformations of eye, ear, face and neck
  • V13.65 – Personal history of (corrected) congenital malformations of heart and circulatory system
  • V13.66 – Personal history of (corrected) congenital malformations of respiratory system
  • V13.67 – Personal history of (corrected) congenital malformations of digestive system
  • V13.68** – Personal history of (corrected) congenital malformations of integument, limbs, and musculoskeletal systems
  • V15.53 – Personal history of retained foreign body fully removed
  • V25.11 – Encounter for insertion of intrauterine contraceptive device
  • V25.12 – Encounter for removal of intrauterine contraceptive device
  • V25.13 – Encounter for removal and reinsertion of intrauterine contraceptive device
  • V49.86 – Do not resuscitate status
  • V49.87* – Physical restraints status
  • V62.85 – Homicidal ideation
  • V85.41 – Body Mass Index 40.0-44.9, adult
  • V85.42 – Body Mass Index 45.0-49.9, adult
  • V85.43 – Body Mass Index 50.0-59.9, adult
  • V85.44 – Body Mass Index 60.0-69.9, adult
  • V85.45 – Body Mass Index 70 and over, adult
  • V88.11 – Acquired total absence of pancreas
  • V88.12 – Acquired partial absence of pancreas
  • V90.01 – Retained depleted uranium fragments
  • V90.09 – Other retained radioactive fragments
  • V90.10 – Retained metal fragments, unspecified
  • V90.11 – Retained magnetic metal fragments
  • V90.12 – Retained nonmagnetic metal fragments
  • V90.2 – Retained plastic fragments
  • V90.31 – Retained animal quills or spines
  • V90.32 – Retained tooth
  • V90.33 – Retained wood fragments
  • V90.39 – Other retained organic fragments
  • V90.81 – Retained glass fragments
  • V90.83 – Retained stone or crystalline fragments
  • V90.89 – Other specified retained foreign body
  • V90.9 – Retained foreign body, unspecified material
  • V91.00 – Twin gestation, unspecified number of placenta, unspecified number of amniotic sacs
  • V91.01 – Twin gestation, monochorionic/monoamniotic (one placenta, one amniotic sac)
  • V91.02 – Twin gestation, monochorionic/diamniotic (one placenta, two amniotic sacs)
  • V91.03 – Twin gestation, dichorionic/diamniotic (two placentae, two amniotic sacs)
  • V91.09 – Twin gestation, unable to determine number of placenta and number of amniotic sacs
  • V91.10 – Triplet gestation, unspecified number of placenta and unspecified number of amniotic sacs
  • V91.11 – Triplet gestation, with two or more monochorionic fetuses
  • V91.12 – Triplet gestation, with two or more monoamniotic fetuses
  • V91.19 – Triplet gestation, unable to determine number of placenta and number of amniotic sacs
  • V91.20 – Quadruplet gestation, unspecified number of placenta and unspecified number of amniotic sacs
  • V91.21 – Quadruplet gestation, with two or more monochorionic fetuses
  • V91.22 – Quadruplet gestation, with two or more monoamniotic fetuses
  • V91.29 – Quadruplet gestation, unable to determine number of placenta and number of amniotic sacs
  • V91.90 – Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs
  • V91.91 – Other specified multiple gestation, with two or more monochorionic fetuses
  • V91.92 – Other specified multiple gestation, with two or more monoamniotic fetuses
  • V91.99 – Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs

* These diagnosis codes were discussed at the March 9-10, 2010 ICD-9-CM Coordination and Maintenance Committee meeting and were not finalized in time to include in the proposed rule. However, they will be implemented on October 1, 2010. Please note that new code 237.78, Other neurofibromatosis, that was listed as a new diagnosis code in the proposed rule has been modified to new code 237.79. New code 799.50, Unspecified signs and symptoms involving cognition, that was listed in the proposed rule as a new code has been deleted and will not be implemented on October 1, 2010.

**The code title has changed from the proposed rule.

2011  · RSS | Published September 8, 2010


2011 ICD-9 Code Updates Are Available Now

New 2011 ICD9 Code UpdatesOctober 1, 2010 is when the New ICD-9 2011 codes take effect. If you neglect to update your existing billing software with the new updates, it could delay claims which then could result in delayed payments. We hope that you’ll take advantage of these resources now to avoid any delay in your payment for services.

2011  · RSS | Published September 3, 2010


Why BDA? 10 Reasons

10 Reasons for BDA10 Benefits from partnering with Bill Dunbar and Associates

REASONSHTTP  · RSS | Published May 26, 2010


Family Practice 2010 ICD-9-CM Quick Reference

ICD-9 and ICD-10 Mouse PadWe’ve created this ICD-9 Quick Reference Mouse Pad in response to Emergency Department coding professionals who want to maximize their speed and efficiency. Fill out the request form below to receive a BDA mouse pad and our newest 2010 ICD-9 Quick Reference Insert.

FAMILY  · RSS | Published March 29, 2010


Occupational Medicine ICD-9-CM Quick Reference

2010 ICD9 Occupational Medicine Lower Back and Other Quick ReferenceWe’ve created this Occupational Medicine Lower Back & Other ICD9 Quick Reference in response to Occupational Medicine coding professionals who want to maximize their speed and efficiency. Fill out the request form to receive a BDA mouse pad and our newest 2010 Occupational Medicine ICD-9 Quick Reference Insert.

ICD  · RSS


2010 ICD-9 Quick Reference for Emergency Departments

ICD-9 and ICD-10 Mouse PadWe’ve created this ICD-9 Quick Reference Mouse Pad in response to Emergency Department coding professionals who want to maximize their speed and efficiency. Fill out the request form below to receive a BDA mouse pad and our newest 2010 ICD-9 Quick Reference Insert.

K-REFERENCE  · RSS | Published March 24, 2010


Invalid ICD-9 Codes for 2010

Invalid 2010 ICD9 UpdatesThe invalid codes are the ICD-9-CM diagnosis codes that are invalid after September 30th, 2009. These codes must be at a higher level of specificity to be valid codes as of October 1, 2009

2010  · RSS | Published March 21, 2010


Revised 2010 ICD-9-CM Updates

2010 Revised ICD9 UpdatesThere are also many revisions to the language that ICD-9 codes use to describe conditions. Without updating the language to ICD-9 codes, a code could be selected improperly causing an incorrect code to be used.

2010  · RSS | Published March 16, 2010


10 Common Mistakes Managing Emergency Department Reimbursement and Cash Flow

A list of 10 Common Mistakes Managing Emergency Dept Reimbursement and Cash Flow, and what you can do to fix them

MANAGING  · RSS | Published January 1, 2010


ACEP – American College of Emergency Medicine

The American College of Emergency Medicine (ACEP) was founded in 1968 by a small group of physicians who shared a commitment to improving the quality of emergency care.

MEDICINE  · RSS


Maintaining Accuracy and Compliance in the Medical Record

Why is accuracy and compliance to accepted standards of documentation in the medical record important? The first and most important reason is to provide patients with appropriate care based on details provided in their medical record. This ensures optimal patient care and allows for excellent patient satisfaction. Another reason for ensuring accuracy and compliance in the medical record is to provide governmental agencies, and any other entity accessing the patient’s medical record accurate and complete information. With improved documentation, collections improve, the risk for unfavorable audit results decreases, and efficiencies are increased in the office with both staff and physician co-workers.

ACCURACY  · RSS | Published October 29, 2009


New ICD-9-CM 2010 Code Updates

2010 Revised ICD9 UpdatesThe New, Revised and Invalid ICD-9 codes take effect October 1, 2009. Each year, BDA provides tools to assist physicians and organizations with the ICD-9 code changes. We’ve put together a Power Point presentation that goes over these changes for you. Neglecting to update your ICD-9 codes annually could delay claims and payments. Take advantage of these resources now so the ICD-9 changes will cause no delay in your payment for services.

2010  · RSS | Published September 16, 2009


2009 ICD-9 Updates here!

Update: See: 2012 ICD9 Code Updates
We have reviewed all of the ICD-9 2009 updates, and compiled a summarized list of all of the changes that need to made in order for you to be compliant.
Claims submitted with invalid/deleted ICD-9 codes for service dates on or after October 1, 2008 will be rejected.
You can view the online slideshow and/or download the PowerPoint by filling out …

ICD  · RSS | Published September 10, 2009


Failing to Compare Providers Coding against a National Benchmark.

The 9th common mistake that can impact reimbursement can occur when your provider does not know where he/she falls on a National E/M Benchmark Bell Curve.

COMPARE  · RSS | Published April 26, 2009


Lack of ongoing education for all of your Providers and Staff

The 10th common mistake that will often affect revenue is an ongoing lack of education for all of your Providers and Staff. They should each receive focused instruction as a direct result of ongoing and consistent chart reviews.

RSS


Not conducting chart reviews on a regular and consistent basis

The 8th common mistake in managing cash flow is due to the lack of chart reviews / audits.

RSS


Not automatically updating your Fee Ticket/Superbill annually

The 7th common mistake occurs as a result of your Fee Tickets / Superbills not being updated on a regular basis.

AUTOMATICALLY  · RSS


Procedure At The Time Of An Office or Post Operative Visit

Procedure at time of patient visitCan my doctor bill a Mirena insertion fee when billing for an office visit or post operative visit or should they have the patient come back?
I want to be sure he gets paid.

RSS | Published November 18, 2008


Choosing and then utilizing the wrong Evaluation and Management guidelines for your ED

The 6th common mistake for revenue capture is relying solely on your EMR to capture the appropriate E/M Level.

GUIDELINES  · RSS | Published July 21, 2008


Failing to document the length of time used for your time based services

Are you capturing your time based procedure / service codes?

RSS


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