Volume 13 Number 1 Jan– Feb - Mar 2014

CODING Network News

Professional Association of Healthcare Coding Specialists (PAHCS) In this edition • I-9 and I-10 comparison • PAHCS I-10 training • CPT changes for 2014 • 10 year members • PAHCS happenings • June 25-27 conference

in Orlando, FL • CMS resources • Mar 19 free I-10 webinar

What You Need to Know about ICD-10

All the hype surrounding ICD-10 gives one the impression it’s going to be VERY difficult to learn and VERY costly. The facts are that ICD-10 isn’t difficult to learn or use and most of the cost associated with its implementation will be caused by a general slowdown due to the software providers, insurance companies, providers and coders all doing “something different”. Reimbursements may slow and software may be an issue, depending on the system you are using and the assistance you get from your vendor(s). To lessen the impact on a practice, we recommend having 6 months of cash available so a minor glitch doesn’t become a catastrophe.

Some simple ways to lessen the impact of ICD-10 implementation:

• Begin now by purchasing a 2014 ICD-9 codebook that has ICD-10 codes listed (or an ICD-10 DRAFT copy). • Coders and Billers in the practice should learn the ICD-10 codes for the specialty and communicate any new

documentation requirements to the provider(s). • Providers need to work with coders and billers and take the initiative to learn what new documentation (if any)

will be required for your specialty. • Make sure everyone who now uses ICD-9 knows what will be expected when ICD-10 happens. • External to the office, contact insurance companies and software providers to ensure they have a plan and will

be ready. Keep in mind, for approximately 6 months coders, billers, insurance companies and software providers will need to use both ICD-9 and ICD-10.

• Visit www.cms.gov/ICD10 and view factsheets and other ICD-10 information, straight from the source. • Be a member of PAHCS, we will help you by providing free training.

NOTE: All claims with date of service before October 1st will use ICD-9. If any of those claims are denied and require resubmission the ICD-9 code will still be used, even after the October 1, 2014 transition. Most of the conventions used for deciding which code to use and how to find them are almost identical between ICD-9 and ICD-10. PAHCS recommends coders review terms of anatomy relevant to their specialty. Practitioners, in most cases, will be required to document to a higher level of specificity than they may be currently comfortable with and coders will need to communicate with them when more information is needed. Under ICD-10, providers will face the most difficult challenges because they may have to change documentation procedures they have been using since they came into the profession. We recommend providers find out now if there are any new documentation requirements for their specialty and, if so, begin documenting to those standards. Mistakes can be made, found and fixed now, after October 1, 2014 those mistakes will cause slower coding and reimbursement issues. The sky is not falling. Practices proactively getting ready to transition to ICD-10-CM will easily make the conversion. Take advantage of all free ICD-10-CM programs available on line. ICD-10-CM isn’t going to be that difficult to learn or to implement, if you prepare now. Don’t wait, the clock is ticking.

Page 2 PAHCS Coding Network News Jan-Feb-Mar 2014

ICD-9-CM Descriptor ICD-10-CM Descriptor

001-139 Infectious and Parasitic Diseases A00-B99 Certain infectious and parasitic diseases

140-239 Neoplasms C00-D48 Neoplasms

240-279 Endocrine, Nutritional, and Metabolic Diseases and Immunity Disorders D50-D89

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism

289-289 Diseases of Blood and Blood Forming Organs E00-E90 Endocrine, nutritional and metabolic diseases

230-319 Mental Disorders F00-F99 Mental and behavioural disorders

320-389 Diseases of Nervous System and Sense Organs G00-G99 Diseases of the nervous system

390-459 Diseases of Circulatory System H00-H59 Diseases of the eye and adnexa

460-519 Diseases of Respiratory System H60-H95 Diseases of the ear and mastoid process

520-579 Diseases of Digestive System I00-I99 Diseases of the circulatory system

580-629 Diseases of Genitourinary System J00-J99 Diseases of the respiratory system

630-677 Complications of Pregnancy, Childbirth, and the Puerperium K00-K93 Diseases of the digestive system

680-709 Diseases Skin and Subcutaneous Tissue L00-L99 Diseases of the skin and subcutaneous tissue

710-739 Diseases of Musculoskeletal and Connec-tive Tissue M00-M99

Diseases of the musculoskeletal system and connective tissue

740-759 Congenital Anomalies N00-N99 Diseases of the genitourinary system

760-799 Newborn (Perinatal) Guidelines O00-O99 Pregnancy, childbirth and the puerperium

780-799 Signs, Symptoms and Ill-Defined Condi-tions P00-P96

Certain conditions originating in the perinatal period

800-999 Injury and Poisoning Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities

V01-V89

Classification of Factors Influencing Health Status and Contact with Health Service R00-R99

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

E800-E999 Supplemental Classification of External Causes of Injury and Poisoning S00-T98

Injury, poisoning and certain other conse-quences of external causes

V01-98 External causes of morbidity and mortality

Z00-Z98 Factors influencing health status and contact with health services

U00-U99 Codes for special purposes

ICD-9 and ICD-10 Chapter comparisons

Jan-Feb-Mar 2013 PAHCS Coding Network News Page 3

CODING

Network News

Volume 13, Number 1

ISSN 1545-4843

Coding Network News is a quarterly publication of the Professional Association of

Healthcare Coding Specialists (PAHCS).

Entire contents copyrighted All rights reserved;

reproduction in whole or in part is prohibited.

Subscriptions are provided as one of the many benefits of

PAHCS membership.

For information on advertising, deadlines for

article submission or reprint permission, FAX the PAHCS National Office 813-333-1596.

STAY IN TOUCH Local: 813-333-1160 Toll Free: 888-708-4707 Fax: 813-333-1596 Mail: 218 E. Bearss Ave., #354 Tampa, FL 33613 Web Site: www.pahcs.org E-mail: pahcs@pahcs.org

PAHCS ICD-10 TRAINING 2014 Webinars, On Demand Videos, PDF Documents

On Demand already available on PAHCS Website Honest Facts about ICD-10 Documentation for ICD-10 Coding with ICD-10 Trainings coming in 2014

Anatomy, Terminology & Physiology

ICD-10 documentation for the Provider

Content & Format of ICD-10-CM

The Coding Process for ICD-10-CM

ICD-10-CM Conventions and Guidelines

Guidelines for Coding:

Diabetes Signs & Symptoms External Causes Neoplasms

Specialty Specific Coding with ICD-10

Gastro Ob/Gyn Cardio/Pulmonary - Circulatory/Respiratory Ortho - Musculoskeletal & Connective Tissue Diseases of the Nervous System Integumenary System - Skin & Subcutaneous Tissue

Page 4 PAHCS Coding Network News Jan-Feb-Mar 2014

NEW CPT CODE HIGHLIGHTS FOR 2014

In this limited space we are showing new and deleted codes for 2014 for specialties most affected. For revised codes and full descriptions of the new codes make sure to check your 2014 CPT book.

ADDITIONS/DELETIONS

ENT – 4 new and 1 deleted

MUSCULOSKELETAL (ORTHO) – 3 new and 2 deleted

NEUROLOGY – 8 new codes and 2 deleted

OB/GYN – 1 deleted code

PULMONARY – 1 new code

UROLOGY – 1 new code and 1 deleted

VACCINES, TOXOIDS – 5 new codes

CHECK YOUR 2014 CPT BOOK FOR CHANGE DETAILS

E/M NEW CODES Interprofessional Telephone/Internet Consultations 99446 99447 99448 99449

NEW CODES Inpatient Neonatal Intensive Care Services & Pediatric & Neonatal Critical Care Services 99481 99482

INTEGUMENTARY NEW CODES 10030 Image-guided fluid collection drainage by catheter, percutaneous

19081-19086 Biopsy, breast with place-ment of breast localization device….

19181-19288 Placement of breast localization device, percutaneous……

DELETED CODES 13150 19102 19103 19290 19291 19295

Jan-Feb-Mar 2013 PAHCS Coding Network News Page 5

CARDIO VASCULAR NEW CODES 33366 Transcatheter aortic valve replacement transapical exposure (eg, left thoracotomy)

34841-34848 Endovascular repair of visceral aorta…..

37217 Transcatheter placement of an intravascular stent(s), interathoracic common carotid artery or innominate artery by retrograde treatment, via open ipsilateral cervical carotid artery exposure…….

37236-37239 Transcatheter placement of intravascular stent(s) (except lower extremity, cervical ca-rotid, exxtracranial vetebraor……) open or percutaneous……

37241-37244 Vascular embolization or occlusion, inclusive of all radiological supervision and inter-pretation, intraprocedural roadmapping………

93582-93583 Percutaneous transcatheter closure of patent ductus arteriosus DELETED CODES 37204-37208 37210

SEE YOUR 2014 CPT BOOK FOR FULL DESCRIPTIONS AND GUIDELINES

DIGESTIVE SYSTEM NEW CODES

43191-43198 Esophagoscopy, rigid, trnasora; diagnostic, including collection of specimen…..

43211-43214 Esophagoscopy with endoscopic mucosal resection; with placement of endoscopic stent….; with dialation of esophagus by balloon….; or with dialation of esophagus with balloon…….

43229 Esophagoscopy with ablation of tumor(s), polyp(s) or other lesions…..

43233 Esophagoscopy with dilation of esophagus with balloon………..

43253-43254 Esophagoscopy with transendoscopic ultrasound guided transmural injection of diagnos-tic or therapeutic substance(s)……. Or with endoscopic mucosal resection

43266 Esophagoscopy with placement of endoscopic stent……

43270 Esophagoscopy with ablation of tumor(s), polyp(s), or other lesions…….

43274-43278 with placement of endoscopic stent into biliary or pancreatic duct……; with removal of foreign body(s)…….; with removal and exchange of stent(s), biliary or pancreatic duct……; with trans-endoscopic balloon dilation of biliary/pancreatic duct(s)…..; or with ablation of tumor(s), polyp(s) or other lesion(s)………. 49405-49407 Laparoscopy introduction, revision, removal peritoneal or retroperitoneal……..

DELETED CODES

SEE YOUR 2014 CPT BOOK FOR FULL DESCRIPTIONS & GUIDELINES

42802 43219 43228

43267-43269 43456 43458

49021 49041 49061

Page 6 PAHCS Coding Network News Jan-Feb-Mar 2014

PAHCS HAPPENINGS

1. Our 2014 National Conference will be June 25-26 and 27 in Orlando, FL • We feel this is necessary due to the ICD-10 implementation date of October 1st. • Topics, speakers and hotel locations will be announced by the end of February.

• Conference fees will remain a $350 per attendee, we hope to see you there.

2. ICD-10-CM free training can be accessed on line. If you can’t attend a live webinar, you can watch it as a video on demand. We also will be providing downloadable documents and specialty material. Visit www.pahcs.org for more information.

3. We need your help to get the word out. PAHCS keeps our prices low and continues to add value to your membership because we don’t spend lots of money on advertisements. We hope you’ll take some time this year and tell your peers about PAHCS and what we offer: Our ICD-10-CM training , no mandatory ICD-10 test requirement to keep credentials, low cost webinars, PAHCS Continuing Education University (CE University) where many CEUs are offered free, PAHCS Network (formerly the list serve) where coders can ask other coders questions and get real answers...and those are just a few of your membership benefits.

4. Certified coders get one free pay per view webinar annually, use the code “freewebinar2014” when checking out.

10 Year members who attended the PAHCS 2013 National Conference in Orlando, FL

Left to Right: Anna Torres, RMC - Marie Demastus COCS - Jo Dick, CENTCS, CMSCS, Marge McQuade, CMSCS, CHCI - Arlene Morrow, CMM, CPC, CMSCS - Joan Browder, CMM, COBGCS - Linda Jackson, CGCS and Dawn Cloud, CPC, CMSCS, CHCI.

Jan-Feb-Mar 2013 PAHCS Coding Network News Page 7

CMS has free recourses for ICD-10

Have questions about the ICD-10 transition? PAHCS recommends visiting the CMS website at www.cms.gov/ICD10/ here you will find resources for providers, vendors, and payers that will be invaluable as you work toward preparing for the transition to ICD-10. CMS has fact sheets available for educating staff and others about the transition, they include:

• The ICD-10 Transition: An Introduction • ICD-10 Basics for Medical Practices • Talking to Your Vendors About ICD-10 • Tips for Medical Practices • Compliance timelines, materials from CMS-sponsored calls and conferences, and

links to resources • Keep up-to-date with CMS on ICD-10 topics at http://www.cms.gov/icd10/

PAHCS ICD-10 training offers a January Webinar

Don’t be afraid of ICD-10 on January 22, 2013 Noon EST Presenter Steve Verno, CMMC, CMMB, NREMT-P, CEMCS, CMSCS

Overview of the differences between ICD-10 and ICD-9 guidelines, coding process, content and format.

March Webinar ICD-10 Documentation for Providers on March 19, 2013 Noon EST

Presenter Dawn Cloud, CPC, CHCI, CMSCS

What your providers will need to know about ICD-10 documentation.

Visit PAHCS sponsors on line:

♦ TurboCoder offers PAHCS members a FREE 2 week trial (log into the member section at www.pahcs.org so you’ll also get a discount if you purchase TurboCoder). There’s no obligation to buy, looking is free.

Also visit other PAHCS sponsors:

♦ BC Advantage @ www.billing-coding.com for coding information and inexpensive CEUs.

♦ InGauge Healthcare Solutions @ www.ingaugehsi.com for coding materials.

PAHCS National Conference June 25-26-27, 2014

Orlando, FL $350 per attendee

SMARTER CODING:

Two heads are better than one

Professional Assn of Healthcare Coding

Specialists 218 E. Bearss Ave. #354

Tampa, FL 33613

Answer all questions below correctly to receive 1 PAHCS CEU. E-mail answers to coder@pahcs.org. Be sure to include your name in the email.

9 Months to ICD-10

1) Take advantage of

all FREE training.

2) Visit CMS.gov for

the latest info

3) Visit PAHCS.org

4) Practice coding to

ICD-10 standards.

5) Work with staff so

everyone knows

ICD-10 standards

First quarter 2014

____ 1. Coding Convention “NEC” stands for which of the following:

____ 2. A combination code is a single code used to classify

____ 3. Words contained within the brackets [ ], provide the coder with:

____ 4. The colon “:” in the Tabular list tells the coder:

____ 5. Symbols, abbreviations, punctuation, and notations in ICD-9-CM are:

a. Not Evaluated Clinically c. Not always classifiable.

b. Negatively E/M Classification d. Not elsewhere classifiable

a. two diagnoses c. A diagnosis with an associated complication

b. A diagnosis with an associated secondary process (manifestation)

d. All of the above

a. opposite phrases c. synonyms, alternative wording, explanatory phrases

b. incomplete terms d. modified terms

a. the terms below complete the term to make it assignable to a given category

b. the correct code is found in Volume 3

c. the terms are synonyms, alternative wording, or explanatory phrases

d. the preceding term is not otherwise specified

a. grammar checks c. conventions

b. guidelines d. edits

First quarter 2014