ICD-10 Coding Guidelines: A Refresher to Rules You May Have Forgotten
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When was the last time you looked up something in the ICD-10-CM Guidelines? How much have you forgotten since you took your certification exam or started in your current job? Have you ever read the guidelines? You would be surprised what you find there. Not only guidance for CoVID-19 coding which is new but “old” sections on coding issues such as diabetes. As medical necessity returns to the forefront of coding with the current PHE changes in E&M coding and documentation, diagnosis coding is more important than ever. Knowing the appropriate way to code utilizing the 3 S’s is imperative. Utilizing the 3 S’s of diagnosis coding will not only help show medical necessity but it can help your HCC coding issues. Can you guess what they are?
Diabetes – what’s all the fuss? Morsels of information to help understand why you need to take the time to discern the specific code(s) needed for the encounter
Hypertension – we all miss 401.9, but it was a lousy, unspecified code. So is ICD-10. What additional details are needed from your provider in the documentation to adequately code for this common illness.
BMI – many carriers want you to include this on every patient on every claim. Why doing this goes against the guidelines and is actually a compliance problem? When do you include the BMI on a claim?
Sepsis – it doesn’t happen often, but when you have to code for sepsis do you remember there are a minimum of 2 codes needed to compliantly code sepsis?
About The Author
Jill M Young, CPC, CEDC, CIMC
Jill M Young, CPC, CEDC, CIMC
Jill has over 30 years of medical experience with a diverse background in all areas from clinical to billing, and many different physician specialties. She has been published in a wide range of periodicals and presented many audio conferences and webinars. She gives educational lectures for the Michigan State Medical Society and other national organizations, including The Coding Institute (TCI) and Eli Research. Jill also presents AAPC workshops and often speaks at AAPC’s National Conference. She is an original member of the AAPCCA board of directors and loves meeting AAPC members at chapter meetings, National Conference, and in her everyday work as a consultant.
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