Recent content by consultingbykristin

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    E&M, missing 1 element (Using 1997 DG's)

    I would interpret the guidelines the same way. They specify when you need 3 out of 7. So when they don't specify you only need so many, it means you need all.
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    Dm + hf

    DM + HF isn't really linked well, if the documentation literally used a + sign, I wouldn't consider that proper linkage. A few things to consider Clinicians should not document with arrows or symbols and if they do, we should never code from it. While heart failure and other heart diseases...
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    Coding Manager Needed

    Coding Manager The Coding Manager will be accountable for successfully managing the Medical Coding team, audit documentation and coding practices to ensure accuracy in the data provided to CMS. The Manager will provide coding expertise as well as administrative oversight to ensure successful...
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    External Cause Codes - comes in for injury

    It's more about correct coding than which insurance requires what codes. That being said, looking at the guidelines, they say "There is no national requirement for mandatory ICD-10-XM external cause code reporting." In the absence of a mandatory reporting, providers are encouraged to...
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    E&M coding with Fever

    I say 99202. MDM is low and while there's a lot of documentation, was it all truly necessary for this visit? Documentation volume should not be considered when assigning a code. There's a lot of family history data that's irrelevant. Also some of the HPI is the same as what is listed in ROS...
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    Wiki Aftercare code for an MI after 4 weeks

    If that's the physician's documentation, I would. He does have to state that it's healed or indicate if there's ongoing issues.
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    Wiki Aftercare code for an MI after 4 weeks

    I don't think I23.8 would be appropriate because that's for complications following an acute MI. the Coding Guidelines indicate encounters occurring while the MI is equal to, or less tham, four weeks old, including tramsfers to another acute setting or a postacute seeting, and the patient...
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    Wiki Excludes 1 & 2 note question

    Was the broken/fracture around the internal prosthetic joint (which is T84.040-) or broken internal hip/knee prosthesis. That's the key to me in looking at this. How is it described. Around the internal joint or actual broken prosthesis. And I think that's why Excludes1 is on the T84.01-...
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    stenosis help

    In I10 they don't reference it as recess stenosis and no longer have the stenosis with neurogenic claudication code (724.03 in I9). If you use the AAPC crosswalk tool, 724.03 goes to M48.06. Spinal stenosis goes to category M48, under this indicates caudal stenosis. In I10 if the cause of the...
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    smoking status non smoker

    The Coding Guidelines has instructions on this. Look there, it also mentions category Z77. Category Z77, other contact with and (suspected) exposures hazardous to health, indicates contact with and suspected exposure. Then also look at the specific chapter guidelines too.
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    Anesthesia webinars???

    webinar Here's a link to an older webinar AAPC had and it's only $40. Decision Health is great, they have a forum that's free. But their training is pretty expensive. The ASA codes haven't...
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    D vs. S for mechanical joint failure

    Patient admitted due to failure of total hip. Underwent revision. For the T84.090- code, would the correct 7th character be an S. The failure is a sequela of the original implant or would it be D for subsequent encounter since patient had surgery and is now being followed by rehab? I'm...
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    Can you use Past Medical History for ROS

    I would only use them if the ROS notes something about patient's diabetes (BS log, numbness or lack of in feet, etc). same with HTN, does patient have any complaints. Otherwise, it's just PMH
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    Pain management Please help with coding

    Reviewed The AMA CPT Reference of Clinical Examples against your report and it looks to me like it's a sacroiliac joint. See CPT 27096
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    History of Coding

    The coding guidelines indicate once the cancer is surgically eradicated and no further treatment is being directed at the malignancy whether it's chemo, radiation or medications such as Tamoxifen, Femara, etc...we are to code as personal history. If the physician's notes do not indicate any...