Look for three things in the documentation to accurately report encounters in ICD-9-CM and ICD-10-CM. According to the American Burn Association, an estimated 486,000 hospital admissions and visits to hospital emergency departments occur annually for burn evaluation and treatment in the United States. An estimated 30,000 more individuals are hospitalized at burn centers for treatment ...
In Billing
Jun 9th, 2014
Injury and poisoning locations are key components of many insurance claims, and especially for workers’ compensation. In ICD-9-CM, use the following codes with the appropriate fourth digit subcategories to identify where accidents occurred: E849.0 – Home E849.1 – Farm E849.2 – Mine and quarry E849.3 – Industrial place and premises E849.4 – Place for recreation ...
May 1st, 2013
ICD-10 is so specific that reporting unspecified codes will raise documentation red flags. By Shelly Cronin, CPC, CPMA, CPPM, CPC-I, CANPC, CGIC, CGSC Diagnosis coding is traditionally viewed as unessential to claims reimbursement; however, with ICD-10 that may change. Payers are going to great lengths to beef up their policies and to map their covered ...
Sep 26th, 2012
When submitting claims to Medicare, be certain that you aren’t listing an ICD-9-CM E code as the first diagnosis, or your claims will be returned to you. E codes describe external causes of injury or poisoning. ICD-9-CM prohibits E codes from being reported as principal diagnoses. The Centers for Medicare & Medicaid Services (CMS) instructs ...
Aug 1st, 2012
By Holly J. Cassano, CPC Proper hierarchal condition category (HCC) classification depends on a plan’s ability to obtain accurate diagnostic HCC information and report that information accurately to the Centers for Medicare & Medicaid Services (CMS). If a plan focuses solely on disease management to decrease costs (neglecting to develop an effective HCC strategy), it ...