E/M Hot Topic: Time

E/M Hot Topic: Time

July 2021

In July’s E/M Hot Topic, Jeanie Heck, our Director of Education, discusses the new guidelines for Time and the Prolonged Time codes. The new 2021 E/M guidelines are significantly different from the way we previously used to account for Time. She also addresses the latest technical corrections regarding Time from the AMA’s webinar at the end of May and gives some documentation template examples to help educate your providers.


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Intellis IQ Podcast “Intellicast”
E/M Hot Topic: Social Determinants of Health

April 2021

With the use of the 2021 E/M Guidelines, questions continue to surface. In this month’s E/M Hot Topic, Director of Education, Jeanie Heck, BBA, CCS, CPC, CRC discusses Social Determinants of Health. She also provides an update to Prescription Drug Management and the Ordering/Review of Tests.


 

For additional information about E/M Guideline Updates education, contact us.

Follow us on LinkedIn to find out when the next E/M Hot Topic is released.


 

E/M Hot Topic: Ordering/Review of Tests

March 2021

As we continue to use the new 2021 E/M Guidelines, many questions continue to surface. In this month’s E/M Hot Topic, Director of Education, Jeanie Heck, BBA, CCS, CPC, CRC discusses the review and/or ordering of tests, independent interpretation of tests, and discussion of management or test interpretation from the data element of MDM.

For additional information about E/M Guideline Updates education, contact us.

The April 2021 E/M Hot Topic:  Social Determinants of Health
Follow us on LinkedIn to find out when the next E/M Hot Topic is released.


 

Today’s Tip: ICD-10 Anemia in CKD

Coding Tip

When anemia NOS is present as a current condition, and the patient has underlying chronic kidney disease (CKD) or end-stage renal disease (ESRD), it is a fast track to the usage of D63.1, Anemia in chronic kidney disease (manifestation). This is assigned unless the anemia is specified as a different form and/or attributed to another condition. Much like the diabetes category, ICD-10-CM “In/With” convention assumes “due to.”


 

ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Section I. A. 15.

“With” 

The word “with” or “in” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index (either under a main term or subterm), or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated or when another guideline exists that specifically requires a documented linkage between two conditions (e.g., sepsis guideline for “acute organ dysfunction that is not clearly associated with the sepsis”).

For conditions not specifically linked by these relational terms in the classification or when a guideline requires that a linkage between two conditions be explicitly documented, provider documentation must link the conditions in order to code them as related. The word “with” in the Alphabetic Index is sequenced immediately following the main term or subterm, not in alphabetical order.

Clinical Insight

Anemia refers to the reduction of the total number of circulating red blood cells. It is diagnosed when there is the detection of decreased hemoglobin concentration, hematocrit, or red blood cell count. Anemia in chronic kidney disease specifically falls under the category of decreased red blood cell production. 

In CKD or ESRD, kidney function is compromised to the point that blood cannot be filtered of wastes and fluid. The kidneys also produce less erythropoietin (EPO), a hormone that signals the bone marrow to produce additional red blood cells. Furthermore, in CKD patients the red blood cells are not able to survive as long in the bloodstream and suffer a premature death. Due to associated nutrient deficiencies in underlying CKD, red blood cells are not reproduced as frequently or with the same cellular integrity as in a healthy patient.

Education Disclaimer: This coding tip is intended to serve the general community and may not account for all differences in coding routines, duties, or individual client policies. The information and opinions presented here are based on the experience, training, and interpretation of the author. Although the information has been researched and reviewed for accuracy, the instructor does not accept any responsibility or liability with regard to errors, omissions, misuse, or misinterpretation. This information is intended as a guide; it should not be considered a legal or consulting opinion or advice.

 

 

Intellis IQ Training for FY 2021 Code Updates: ICD-10-CM, ICD-10-PCS

Keeping up with the annual updates and guidelines is a challenge for coding professionals and facility leaders. Intellis overcomes the challenge by providing tailored IQ Education that prepares coders on the frontlines to ensure their facilities are always ready for new rules. 

Are you ready for October 1?

For the year 2021, ICD-10-CM official guidelines reflect over 500 significant changes. The updates include 490 new codes, 47 revised codes, and 58 codes deemed invalid. In addition, the upcoming fiscal year ICD-10-PCS code set includes 544 new codes and the recently released FY 2021 ICD-10-PCS Official Guidelines for Coding and Reporting. Effective date: October 1, 2020.

Find out more!

Right now, Intellis is offering robust training to help organizations prepare for FY 2021 ICD-10-CM, ICD-10-PCS updates. The sessions are presented by Intellis VP of Education & Training Kim Felix, RHIA, CCS a nationally recognized Intellis IQ subject matter expert.

We’re committed to helping coding teams prepare, and we provide personal service to make sure your education experience goes smoothly.

Get the details: request more info, or register now.

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