The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association's Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), and professional organizations such as the American Medical Association (AMA). Because the information included in the Coding Clinic is considered an official resource is it important to pay attention to their publications.
Usually there isn't much related specifically to chiropractic care, but the Quarter 3, 2018 Coding Clinic addressed the coding of lumbar spondylolisthesis with radiculopathy. There is no available combination code which identifies both conditions so it is necessary to code both the spondylolisthesis (M43.1-) AND the radiculopathy (M54.1-) according to the anatomic site. The AHA article specifically answered a question about coding L4-L5 spondylolisthesis with radiculopathy and their answer stated that you should NOT use use a code from category M51.1- “M51.1 Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy” because spondylolisthesis is not an intervertebral disc disorder. They stated:
“In spondylolisthesis, the bony vertebra slips. A disc disorder typically involves herniation or displacement of the interior disc.” - AHA Coding Clinic 2018; Volume 5 Issue 3
These definitions are now considered official and should be kept in mind when making a code selection (e.g., M51- intervertebral disc disorder codes).
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To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number.
Take a look at the following
J1071 - Injection, testosterone cypionate, 1mg
For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL
(100 mg/mL = 1 mL and there are ...
As we begin returning back to work, we will all face a new normal. The COVID-19 pandemic has changed the face of business. While it has certainly been a challenge to keep up with the ever-changing regulations (that’s likely to continue for a little longer), exciting new opportunities have also been created, such as the expansion of telemedicine. There’s also the maze of government funding that needs to be navigated and an increased awareness of OSHA standards to implement.
The CDC has released additional information and coding guidance for reporting encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI).
The update offers coding scenarios for general guidance, poisoning and toxicity, substance abuse and signs and symptoms.
ICD-10-CM Official Coding Guidelines - ...
On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.
Risk adjustment is simply a way of making sure that there are sufficient funds to adequately take care of the healthcare needs of a certain population. It’s a predictive modeling methodology based on the diagnoses of the individuals in that population. As payers move to value based models, they heavily rely on risk adjustment to ensure proper funding.
All healthcare providers who are currently participating in the MIPS portion of Medicare’s Quality Payment Program may want to participate in the new COVID-19 Clinical Trials improvement activity. Read more about it here.
With all the new laboratory test codes that have been added due to the current public health emergency (PHE), there are a few additional guidelines CMS has released about collecting samples to perform the testing. Please keep in mind that these guidelines are by CMS and may or may not apply to other commercial payer policies.