Category Archives: ICD-10

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10); ICD-10-CM, ICD-10-PCS; ICD-9-CM; ICD-10-CM Clinical Modification; inpatient coding standard; granular; granularity; specificity; GEMs; general equivalence mappings; transition to ICD-10; new coding rules; coding regulations

HIMagine That! Coder Agreement

Donna: Sue, what results are you hearing about ICD-10 coder agreement as sites get ready to implement October 1, 2015?

Sue: What do you mean by “ICD-10 coder agreement?”

Donna: Well, as hospitals are in the homestretch of their ICD-10 preparation activities, one of the things they’re doing is having all of their coding staff code the same cases in ICD-10 so they can compare results. Continue reading

Taking a Closer Look at the May ICD-10 Coding Challenge

CHALLENGE QUESTION

A 37-year old male was found unresponsive in a bedroom at his home by a family member. Paramedics arrived and found the patient pulseless and not breathing. The patient’s skin was cool and cyanotic. The family member said the patient had been using Oxycodone for long-standing back pain for the past two to three years. A prescription bottle for the drug was found at the scene. The patient was transported to a nearby Emergency Room where he was pronounced dead. The Emergency Room physician recorded the diagnoses of: Continue reading

ICD-10: One Small Step for Health Care—Politics Can Take a Hike

If no further weird politics intervene, we will be able to use ICD-10 codes for real, finally, beginning October 1, 2015.

This experience has been emotionally draining for everyone. For years now we have worked in good faith toward what should have been a modest, straightforward and totally un-newsworthy goal—upgrading an old transaction infrastructure. Imagine this headline: “Old Wiring in the Basement Replaced.” That’s about how exciting ICD-10 implementation should have been. Continue reading

Revenue Neutrality in ICD-10: How Will You Know?

No one likes surprises, especially when it comes to financial performance. In order to reduce unexpected results, many hospitals and payers have decided to address the issue up front. You can call it risk reduction, revenue neutrality, or negotiated reimbursement, but in all cases the goal is to reduce the financial impact ICD-10 has on your organization. Continue reading

HIMagine That! The 3M Client Experience Summit

Donna: Hi Sue! I had a great week at the 3M Client Experience last week! How about you?

Sue: Me, too! It was so nice meeting customers face-to-face and hearing about the cool and interesting things they’re doing in their organizations. Continue reading

HIMagine That! In Spain: ICD-10, por favor

Donna: Hola! How was your trip to Spain?

Sue: My trip was great! I really enjoyed sharing ICD-10 experiences with our customers there.

Donna: When are they transitioning to ICD-10? Continue reading

Taking a Closer Look at the March ICD-10 Coding Challenge

CHALLENGE QUESTION:

A 62-year old male who was diagnosed with pancreatic cancer two weeks ago, was admitted to the hospital with malaise, fever, and an elevated WBC of 15.21 k/uL. The patient was diagnosed with sepsis. Blood cultures were positive for carbapenem-resistant Enterobacteriaceae (CRE). Infectious Diseases was consulted. A review of the patient’s history revealed that the patient had undergone an ERCP with biopsy of the pancreas approximately two weeks ago at which time a diagnosis of cancer of the head of the pancreas was made. It was eventually determined that the patient had been contaminated with the CRE organism from the duodenoscope used during the ERCP. The patient was discharged to an extended care facility with a PICC line for ongoing IV antibiotic therapy. Assign diagnosis codes for this inpatient encounter and sequence appropriately. Continue reading

SGR and ICD-10: Time for Spring Cleaning

It’s that time of year again. For people not working in the healthcare industry, it’s time for flowers to start blooming, windows to be opened to fresh air, swimsuit shopping and, even though we had a short-lived blizzard in Colorado yesterday, I’m ready for spring! Let the spring cleaning begin. However, there is the painful memory of last year, when ICD-10 was delayed “at least until October 1, 2015” via the SGR repeal bill, also known as the doc fix bill. I remember exactly where I was when I heard the news. Continue reading

HIMagine That! Codes and Kangaroos Down Under

Donna: Hello from Down Under where they have been using ICD-10 since 1999!

Sue: Hi! How has your work and your visit been going? Have you learned any ICD-10 tips worth sharing? Continue reading

Taking a Closer Look at the February ICD-10 Coding Challenge

CHALLENGE QUESTION:

An 11-year old boy with severe autism presents to the Emergency Department with a fall from a 4-5 foot round hay bale. He landed backwards on his left arm and chest two hours ago at his family’s farm. His father was present at the time of the fall and states that he did not lose consciousness, but might have “gotten the wind knocked out of him.” He got up afterwards and was ambulatory. His parents brought him in because he was not moving his left arm and was supporting it with his right arm. On examination, the left arm is minimally swollen and there is moderate pain. Pain is relieved with positioning and immobilization of the arm. The exam was difficult due to pain and the patient’s autism. Intranasal fentanyl was administered so proper assessment could be completed. Continue reading