The Impact of Coding on Maternal Outcomes

April 25th, 2022 - Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Categories:   Coding  

This area of coding is not so easy.

While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact, the U.S. has twice as many maternal deaths than other high-income countries.

To reverse this trend, The Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and the Agency for Healthcare Research and Quality (AHRQ) are focusing on the Centers for Disease Control and Prevention (CDC) measure of severe maternal morbidity (SMM). This measure is also a key metric used by state Perinatal Quality Collaboratives, in partnership with the Alliance for Innovation on Maternal Health (AIM), a national (U.S. Department of Health and Human Services, HHS) data-driven maternal safety and quality improvement initiative. AIM has developed national safety bundles (e.g. hemorrhage, hypertension, reducing primary Cesarean delivery) with the goal of reducing SMM and preventable maternal deaths in the U.S. 

In late 2022/early 2023, The Joint Commission, together with CMS, will be introducing a risk-adjusted version of SMM (PC-07) suitable for all hospitals with maternity services. AIM hospital data is currently collected on a state-by-state basis. In some states, the local AIM initiative is coordinated by the state hospital association; in other states, multi-stakeholder quality improvement organizations have taken the lead. The quality indicators used by the AIM program are often based on ICD-10 codes; some of the AIM quality indicators are also utilized in The Joint Commission’s perinatal core measure set. 

The SMM rate identifies women during the birth hospitalization that experience any of the following severe complications:

  • Acute myocardial infarction
  • Aneurysm
  • Acute renal failure
  • Adult respiratory distress syndrome
  • Amniotic fluid embolism
  • Cardiac arrest/ventricular fibrillation
  • Conversion of cardiac rhythm
  • Disseminated intravascular coagulation
  • Eclampsia
  • Heart failure/arrest during surgery or procedure
  • Puerperal cerebrovascular disorders
  • Pulmonary edema/acute heart failure
  • Severe anesthesia complications
  • Sepsis
  • Shock
  • Sickle cell disease with crisis
  • Air and thrombotic embolism
  • Blood products transfusion
  • Hysterectomy
  • Temporary tracheostomy
  • Ventilation

...

Read the entire article at ICD10monitor by clicking here.

This article originally published on October 18, 2021 by ICD10monitor.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....
Can We Score Interpretation of an EKG Towards E/M Medical Decision Making?
October 10th, 2023 - Aimee Wilcox
When EKGs are performed in the facility setting or even in the physician's office, what are the requirements for reporting the service and who gets credit for scoring data points for Evaluation and Management (E/M) medical decision making (MDM)? Let's take a look at a few coding scenarios related to EKG services to get a better understanding of why this can be problematic.
Accurately Reporting Signs and Symptoms with ICD-10-CM Codes
October 5th, 2023 - Aimee Wilcox
Coders often find themselves unsure of when to report a sign or symptom code documented in the medical record. Some coders find their organization has an EHR that requires a working diagnosis, which is usually a sign or symptom, be entered to order a test or diagnostic study or image. Understanding the guidelines surrounding when signs and symptoms should be reported is the first step in correct coding so let's take a look at some scenarios.
The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin Resistance
September 19th, 2023 - Aimee Wilcox
Diabetes is a chronic disease that just seems to consistently be increasing instead of improving resulting in a constant endeavor by medical researchers to identify causal effects and possible treatments. One underlying or precipitating condition that scientists have identified as a precipitating factor in the development of diabetes is insulin resistance, which is a known metabolic disorder. As data becomes available through claims reporting, additional code options become possible with ICD-10-CM.
Documenting and Reporting Postoperative Visits
September 12th, 2023 - Aimee Wilcox
Sometimes we receive questions regarding documentation requirements for specific codes or coding requirements and we respond with information and resources to support our answers. The following question was recently submitted: Are providers required to report postoperative services on claims using 99024, especially if there is no payment for that service? What documentation is required if you are reporting an unrelated Evaluation and Management (E/M) service by the same physician during the postoperative period? 
Understanding Gastroesophageal Reflux Disease and ICD-10-CM Coding
August 22nd, 2023 - Aimee Wilcox
Gastroesophageal reflux disease or GERD for short, is a disease that impacts millions of Americans on a weekly basis. Symptoms are uncomfortable, as are some of the tests used to diagnose it, but understanding the disease, tests, and treatments helps us better understand how to code the disease using ICD-10-CM codes.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2023 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association