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It there too many codes?

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    Exam Training Packages
    Because most ER facility coding, you use the dx procedure codes. Been trying to tell you that for a while. The volume III codes are not just for inpatient.. they are for FACILITY, which also includes inpatient.

  2. #12
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    Columbia, MO
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    Sorry but volume 3 codes are inpatient only. From the coding guidelines:
    "The diagnosis codes (Volumes 1-2) have been adopted under HIPAA for all healthcare settings. Volume 3 procedure codes have been adopted for inpatient procedures reported by hospitals".
    Volume 3 codes do not belong on an outpatient claim ever.
    They are not dx procedure codes either.
    Vol 1&2 are diagnosis codes
    Vol 3 are procedure codes for inpatient procedures
    I am so looking forward to ICD-10, and there will no longer be a volume 3.
    Last edited by mitchellde; 08-15-2010 at 09:57 AM.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Like trying to talk to a brick wall. I guess the thousands of ER facilities that use volume III codes on the FACILITY procedures are all wrong and you are the only right one. Why does this not surprise me?

  4. #14
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    I am not sure why you find it necessary to be so rude in your replies. However I have given you numerous sources that support why you do NOT use vol III codes for ER facility. I am really interested in what OFFICIAL source you are using. Just because your facility uses them with your encoder does not mean these are used for reporting facility outpatient procedures. Per the federal register:
    B. ICD–9–CM, Volume 3 (Procedures)
    Inpatient hospital services procedures
    are currently coded using ICD–9–CM
    Volume 3, which was adopted as a
    HIPAA standard in 2000 for reporting
    inpatient hospital procedures. Current
    Procedural Terminology, 4th Edition
    (CPT–4) and Healthcare Common
    Procedure Coding System (HCPCS) are
    used to code all other procedures. The
    ICD–9–CM procedure codes, which are
    maintained by CMS, are three to four
    digits long and organized into chapters
    by body system (for example,
    musculoskeletal, urinary and circulatory
    systems, etc.). For a discussion of the
    structure of the ICD–9–CM procedure
    code set, please refer to the August 22,
    2008 proposed rule (73 FR 49798).

    Also I worked in the facility ER and we did not use Vol III ever for the ER procedures. The encoder however was set for DRG reporting and did report and require the Vol III codes until we pointed out that this was incorrect. The IT department then corrected this so that the encoder could be set for APC reporting and the Vol III codes never appeared again. This is what I referr to in your case a facility specific issue. If you are putting them in your system them someone in the billing department must remove them before the claim can be submitted or it will reject. This is inefficient and can be corrected at the coding level.
    Please try to be professional and respectful in your comments in the future.
    Last edited by mitchellde; 08-15-2010 at 04:54 PM.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Yet again, you keep telling people they are wrong when they use the volume III codes on the facility side of the ER. However, do you ever think that possibly you are wrong, being I have told you this many times before. I have coded for over 250 ERs both professional and facility. A good 75% or more use the volume III codes on the procedures, again on the facility side. I do not code with an encoder. Exactly how many hospitals have you performed ER facility coding for?

  6. #16
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    Columbia, MO
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    I am only asking from what official reporting source are you obtaining this information? It is wrong to report volume III codes for the ER on the facility side. The claim will not process for payment with these codes. ER reimbursement is based on HCPCS codes. I have given you the HIPAA statemnt from both the coding guidelines and the federal register that support this position. My resume is not up for discussion.

    Debra A. Mitchell, MSPH, CPC-H

  7. #17
    Location
    North Carolina
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    I'm a little disturbed by the tone in some of these threads. I've always found Debra to be very helpful and I'm not sure why some of the comments in these threads sound so harsh.

    I don't work on the facility side but Debra's information sounds accurate.

    "Volume 3 procedure codes have been adopted for inpatient procedures reported by hospitals."

    http://www.cdc.gov/nchs/data/icd9/icdguide09.pdf

    - ICD-9-CM Procedure Codes

    "ICD-9-CM procedure codes are required for inpatient hospital Part A claims only."

    https://www.cms.gov/transmittals/Downloads/R126CP.pdf

    If I'm missing something, please share...

  8. #18
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    Thank You Rebecca, I always appreciate your support and links.

    Debra A. Mitchell, MSPH, CPC-H

  9. #19
    Location
    Sioux Falls South Dakota
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    This forum is no place for personal attacks. I have always found Debra's answers helpful and respectful (even if my question might have seemed "stupid" to someone else).

    That said, I worked for the payer side for many years - if an OP or ER claim was filed to us with Vol 3 codes, we denied it - if filed electronically, the claim would not make it past the clearing house because of the edits, and would be returned to the billing entity. Only if the type of bill indicated IP would the Vol 3 codes be allowed to come through.

    Please, no more personal attacks - it is so unprofessional, and these forums are here for us to help one another.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  10. #20
    Location
    Columbia, MO
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    Thank You Cindy, I do appreciate your support and view from the payer side.

    Debra A. Mitchell, MSPH, CPC-H

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