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Are You Certain That Your Hospital Is Correctly Coding For Every Emergency Care Procedure And Service?
Comparing your hospital’s E/M distribution with CMS’ national distribution will help you assess the accuracy of your hospital’s E.D. visit code assignment. CMS has indicated that the distribution of E.D. E/M codes should reflect a normal bell curve.
In addition to the complex issues to documenting and coding E.D. E/M levels, there are complex coding rules surrounding the high volume Hydration, Injection and Infusion codes.
CPT Code
Description …
Revised 2012 ICD-9 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 revised 2012 ICD9 changes for you, which you may view or download below. We also have a presentation covering the New ICD-9 Codes for 2012.
New 2012 ICD-9 Code Updates
The New, Revised and Invalid ICD-9-CM codes take effect October 1, 2011. 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. Take advantage of these resources now so the ICD-9 changes will cause no delay in your payment for services.
Revised 2011 ICD-9 Updates
October 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– Schwannomatosis237.79*– Other neurofibromatosis275.01– Hereditary hemochromatosis275.02– Hemochromatosis due to repeated red blood cell transfusions275.03– Other hemochromatosis275.09– Other disorders of iron metabolism276.61– Transfusion associated circulatory overload276.69– Other fluid overload278.03– Obesity hypoventilation syndrome287.41– Posttransfusion purpura287.49– Other secondary thrombocytopenia315.35*– Childhood onset fluency disorder447.70– Aortic ectasia, unspecified site447.71– Thoracic aortic ectasia447.72– Abdominal aortic ectasia447.73– Thoracoabdominal aortic ectasia488.01*– Influenza due to identified avian influenza virus with pneumonia488.02*– Influenza due to identified avian influenza virus with other respiratory manifestations488.09*– Influenza due to identified avian influenza virus with other manifestations488.11*– Influenza due to identified novel H1N1 influenza virus with pneumonia488.12*– Influenza due to identified novel H1N1 influenza virus with other respiratory manifestations488.19*– Influenza due to identified novel H1N1 influenza virus with other manifestations560.32– Fecal impaction724.03– Spinal stenosis, lumbar region, with neurogenic claudication752.31– Agenesis of uterus752.32– Hypoplasia of uterus752.33– Unicornuate uterus752.34– Bicornuate uterus752.35– Septate uterus752.36– Arcuate uterus752.39– Other anomalies of uterus752.43– Cervical agenesis752.44– Cervical duplication752.45– Vaginal agenesis752.46– Transverse vaginal septum752.47– Longitudinal vaginal septum780.33– Post traumatic seizures780.66– Febrile nonhemolytic transfusion reaction784.52*– Fluency disorder in conditions classified elsewhere784.92– Jaw pain786.30– Hemoptysis, unspecified786.31– Acute idiopathic pulmonary hemorrhage in infants [AIPHI]786.39– Other hemoptysis787.60– Full incontinence of feces787.61– Incomplete defecation787.62– Fecal smearing787.63– Fecal urgency799.51– Attention or concentration deficit799.52– Cognitive communication deficit799.53– Visuospatial deficit799.54– Psychomotor deficit799.55– Frontal lobe and executive function deficit799.59– Other signs and symptoms involving cognition970.81– Poisoning by cocaine970.89– Poisoning by other central nervous system stimulants999.60– ABO incompatibility reaction, unspecified999.61– ABO incompatibility with hemolytic transfusion reaction not specified as acute or delayed999.62– ABO incompatibility with acute hemolytic transfusion reaction999.63– ABO incompatibility with delayed hemolytic transfusion reaction999.69– Other ABO incompatibility reaction999.70– Rh incompatibility reaction, unspecified999.71– Rh incompatibility with hemolytic transfusion reaction not specified as acute or delayed999.72– Rh incompatibility with acute hemolytic transfusion reaction999.73– Rh incompatibility with delayed hemolytic transfusion reaction999.74– Other Rh incompatibility reaction999.75– Non-ABO incompatibility reaction, unspecified999.76– Non-ABO incompatibility with hemolytic transfusion reaction not specified as acute or delayed999.77– Non-ABO incompatibility with acute hemolytic transfusion reaction999.78– Non-ABO incompatibility with delayed hemolytic transfusion reaction999.79– Other non-ABO incompatibility reaction999.80– Transfusion reaction, unspecified999.83– Hemolytic transfusion reaction, incompatibility unspecified999.84– Acute hemolytic transfusion reaction, incompatibility unspecified999.85– Delayed hemolytic transfusion reaction, incompatibility unspecifiedE000.2– Volunteer activityV11.4– Personal history of combat and operational stress reactionV13.23– Personal history of vaginal dysplasiaV13.24– Personal history of vulvar dysplasiaV13.62– Personal history of other (corrected) congenital malformations of genitourinary systemV13.63– Personal history of (corrected) congenital malformations of nervous systemV13.64– Personal history of (corrected) congenital malformations of eye, ear, face and neckV13.65– Personal history of (corrected) congenital malformations of heart and circulatory systemV13.66– Personal history of (corrected) congenital malformations of respiratory systemV13.67– Personal history of (corrected) congenital malformations of digestive systemV13.68**– Personal history of (corrected) congenital malformations of integument, limbs, and musculoskeletal systemsV15.53– Personal history of retained foreign body fully removedV25.11– Encounter for insertion of intrauterine contraceptive deviceV25.12– Encounter for removal of intrauterine contraceptive deviceV25.13– Encounter for removal and reinsertion of intrauterine contraceptive deviceV49.86– Do not resuscitate statusV49.87*– Physical restraints statusV62.85– Homicidal ideationV85.41– Body Mass Index 40.0-44.9, adultV85.42– Body Mass Index 45.0-49.9, adultV85.43– Body Mass Index 50.0-59.9, adultV85.44– Body Mass Index 60.0-69.9, adultV85.45– Body Mass Index 70 and over, adultV88.11– Acquired total absence of pancreasV88.12– Acquired partial absence of pancreasV90.01– Retained depleted uranium fragmentsV90.09– Other retained radioactive fragmentsV90.10– Retained metal fragments, unspecifiedV90.11– Retained magnetic metal fragmentsV90.12– Retained nonmagnetic metal fragmentsV90.2– Retained plastic fragmentsV90.31– Retained animal quills or spinesV90.32– Retained toothV90.33– Retained wood fragmentsV90.39– Other retained organic fragmentsV90.81– Retained glass fragmentsV90.83– Retained stone or crystalline fragmentsV90.89– Other specified retained foreign bodyV90.9– Retained foreign body, unspecified materialV91.00– Twin gestation, unspecified number of placenta, unspecified number of amniotic sacsV91.01– 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 sacsV91.10– Triplet gestation, unspecified number of placenta and unspecified number of amniotic sacsV91.11– Triplet gestation, with two or more monochorionic fetusesV91.12– Triplet gestation, with two or more monoamniotic fetusesV91.19– Triplet gestation, unable to determine number of placenta and number of amniotic sacsV91.20– Quadruplet gestation, unspecified number of placenta and unspecified number of amniotic sacsV91.21– Quadruplet gestation, with two or more monochorionic fetusesV91.22– Quadruplet gestation, with two or more monoamniotic fetusesV91.29– Quadruplet gestation, unable to determine number of placenta and number of amniotic sacsV91.90– Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacsV91.91– Other specified multiple gestation, with two or more monochorionic fetusesV91.92– Other specified multiple gestation, with two or more monoamniotic fetusesV91.99– 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 ICD-9 Code Updates Are Available Now
October 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.
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
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.
New ICD-9-CM 2010 Code Updates
The 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.
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.
Procedure At The Time Of An Office or Post Operative Visit
Can 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.
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.
Failing to consistently educate all members of your ED staff regarding your Point System
A 3rd common mistake is the inconsistent interpretation of the point system by the staff. Once the point system is developed, it is imperative for all staff members to accurately and consistently interpret not only how the point system is being used, but also how it was intended to be used.
Pros and Cons to EMR
The Pros and Cons of EMR.. It seems that it was not too long ago when we were all told how new technologies like cell phones, voice mail, and email would make our lives less complicated!
Medical Abbreviations and prefix/suffix medical terms
List of commonly used medical and financial acronyms and abbreviations.
E/M level billed by Physician the same as Facility
The #1 Most Common Mistake occurs when your staff believes that the Evaluation and Management [E/M] level billed by the ED Physician must be the same level as that billed by the hospital for the ED Facility.
Facility Coding- How Effective is Your Point System?
As there is currently no national standard for point systems, hospitals at this point are required to develop and follow their own system for assigning the ED levels. When you do this, be sure that there are written guidelines with criteria for coding each of the five levels of ED codes, as well as for critical care.
HL7 Standards
Hospitals and other healthcare provider organizations typically have many different computer systems used for everything from billing records to patient tracking. All of these systems should communicate with each other (or “interface”) when they receive new information but not all do so.
Items to Consider before Purchasing an EMR
- Do you want to improve patient care or efficiency of the office?
- Cost concerns?
- EMR’s are difficult to implement
- You will need a project team
- Does this team understand the day to day patient flow
- E/M guidelines
- Visit templates
The Nuances of Occupational Health CD
Profitability and Revenue
This audio features a discussion regarding some of the factors impacting the profitability and revenue of today’s Occupational Healthcare Professionals,
featuring David Dann and Cheryl Carr.
Excerpt from CD Transcript
David:
There are a lot of nuances to occupational health and it is a highly complex component of the health care delivery system. In a previous life I used to be CEO of a large midwestern occupational …
BDA shares its 20+ years experience of documentation and coding with its clients, which often results in increased revenue, improved compliance, and continued growth.
BDA will conduct one-on-one and group sessions with your providers and support staff where we will emphasize the necessity of appropriate documentation needed to support Evaluation and Management (E/M) Services Coding, and overall medical coding. A variety of training tools are utilized for easy future reference.
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Improve Revenue, Reduce Errors: BDA ClaimCorrect ®
Our Process
BDA utilizes several proprietary national fee databases with Geozip specific information, so that it can conduct a comprehensive assessment of your current fee profile.
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BDA provides its clients with a detailed summary that identifies key coding issues such as invalid, deleted or revised codes and descriptive changes. A customized Action Plan is developed and implemented over the life of the engagement.
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