SDOH and IP Reimbursement
- Z59.00 (Homelessness, unspecified)
- Z59.01 (Sheltered homelessness)
- Z59.02 (Unsheltered homelessness)
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refers to the placement of a specialized hollow bore needle through the cortex of a bone into the medullary space for infusion of medical therapy. It is used when standard venous access would delay therapy or is not easily obtained. IO success rates are twice as high as intravenous line placement in critical trauma patients without a blood pressure and should have priority over IV placement and is a highly underutilized technique. IO can be used to administer any substance that is infusible intravenously, but IO use should not be for longer than 24 hours due to an increased risk of complications.
This codes to ‘Transfusion into Bone Marrow’ in ICD-10-PCS. ICD-10-PCS Book snapshot:
Device Names to look for: First Access for Shock and Trauma (FAST1), the EZ-IO, Bone Injection Gun (BIG), Jamshidi needle, Diekman modified needle
Common IO Access Sites include: Sternum, clavicle, humeral head, iliac crest, distal femur, proximal tibia, distal tibia, calcaneus
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Intellis is dedicated to elevating the business of healthcare. We are committed to offering support and the most current information and updates to collaborate with coding and CDI professionals to realize their fullest potential. We enthusiastically seek opportunities to develop ourselves and each other. We understand that knowledge is the key to success for our clients navigating the ever-changing health information management landscape.
Our team offers quarterly coding clinic reviews, coding clinic reviews for CDI, and other valuable courses.
Laser interstitial thermal therapy was deleted from the Radiation Therapy Section (D) in ICD-10-PCS in FY 2023. It has been re-classified to the Medical/Surgical Section (0) since, technically, it is ‘thermal therapy,’ not ‘radiation therapy.’ These codes have been re-classified in the MS-DRG system according to their body system. LITT uses laser probe-generated heat to destroy soft tissue at targeted sites. Used to treat tumors in places that are hard to reach with conventional surgery.
What is LITT
Laser interstitial thermal therapy (LITT) is a minimally invasive surgical technique that uses a small laser to destroy unhealthy brain tissue. It can be an effective treatment option for recurrent brain tumors, radiation necrosis, and tumors that form deep within the brain. It is also used to treat certain types of epilepsy.
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Need help earning CEUs or educating your team? Visit the Intellis IQ Education Center and get your free account.
Intellis is dedicated to elevating the business of healthcare. We are committed to offering support and the most current information and updates to collaborate with coding and CDI professionals to realize their fullest potential. We enthusiastically seek opportunities to develop ourselves and each other. We understand that knowledge is the key to success for our clients navigating the ever-changing health information management landscape.
Our team offers quarterly coding clinic reviews, coding clinic reviews for CDI, and other valuable courses.
New codes were assigned for refractory angina pectoris in FY 2023. These codes will differentiate refractory angina pectoris from other angina types and help ensure precise data collection coding.
Chronic refractory angina pectoris is angina caused by irreversible ischemia, lasting more than three months, and not controlled by a combination of medication, PCI, or CABG. Caring for patients with refractory angina pectoris is challenging since treatment options are limited and further revascularization is contraindicated. These patients are unsuitable for or at higher risk for PCI and CABG surgery.
Learn more about Intellis IQ coding services. Our solutions are leading the way in the HIM industry.
Looking for coding help?
Learn more about Intellis IQ coding services. Our solutions are leading the way in the HIM industry.
Intellis coding education
Need help earning CEUs or educating your team? Visit the Intellis IQ Education Center and get your free account.
Intellis is dedicated to elevating the business of healthcare. We are committed to offering support and the most current information and updates to collaborate with coding and CDI professionals to realize their fullest potential. We enthusiastically seek opportunities to develop ourselves and each other. We understand that knowledge is the key to success for our clients navigating the ever-changing health information management landscape.
Our team offers quarterly coding clinic reviews, coding clinic reviews for CDI, and other valuable courses.
FY 2023 includes new codes for Hemolytic uremic syndrome (HUS), category D59.3-. Hemolytic uremic syndrome (HUS) occurs when the small blood vessels in the kidneys become damaged and inflamed. This damage can cause clots to form in the vessels. The clots clog the filtering system in the kidneys and can lead to kidney failure, which could be life-threatening. HUS often occurs as a complication of a diarrheal infection (usually E. Coli). It is most commonly found in children who are less than five years old or people with weakened immune systems, such as those with cancer, HIV/AIDS, or a previous transplant.
Our coding clinic review education is offered each quarter on our education platform — Intellis IQ Center. The courses highlight information that may help coders and CDI specialists obtain the clarification needed for appropriate coding.
New codes related to respiratory acidosis are now in place.
Acute respiratory acidosis is now indexed to J96.02 (Acute respiratory failure with hypercapnia).
Chronic respiratory acidosis is now indexed to J96.12 (Chronic respiratory failure with hypercapnia).
Respiratory acidosis unspecified remains indexed to E87.29 (Other acidosis).
Definitions
Acute respiratory acidosis occurs when carbon dioxide builds up very quickly before the kidneys can return the body to a state of balance.
Chronic respiratory acidosis occurs over a long time. This leads to a stable situation because the kidneys increase body chemicals, such as bicarbonate, that help restore the body’s acid-base balance.
Respiratory acidosis is a condition that occurs when your lungs can’t remove all of the carbon dioxide produced by your body. This causes the blood and other body fluids to become too acidic.
Significant E/M changes are coming in 2023! Jeanie Heck, our director of Education, will begin her E/M Hot Topic series this month with an overview of these changes. Subsequent monthly E/M Hot Topic presentations will provide a deeper dive into the individual categories affected by these new changes.
For additional information about E/M Guideline Updates education, contact us.
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Providers often use the terms hyperlipidemia and hypercholesterolemia interchangeably. Technically, hyperlipidemia is a high or elevated lipid/fat level in the blood. High blood cholesterol is a lipid disorder. As a result, when hyperlipidemia and hypercholesterolemia are both documented in the record, only assign code E78.00 (Pure hypercholesterolemia) per Coding Clinic, Second Quarter 2022. On the other hand, when ‘mixed hyperlipidemia’ and ‘hypercholesterolemia’ are both documented, assign code E78.2 (Mixed hyperlipidemia). In this example, hypercholesterolemia is included in the E78.2 code.
Meconium gives the amniotic fluid a greenish color. This is called meconium staining. Coding Clinic, Second Quarter 2022 clarifies ‘light meconium-stained fluid’ and how to code it. The presence of any meconium staining may indicate fetal distress, therefore code O77.0 (Labor and delivery affected by meconium in amniotic fluid) is appropriate to code if documented as such. There does not need to be documentation of fetal distress or maternal conditions to code.
2022 ICD-10-CM CODE O77.0
Eliquis can be used as an anticoagulant or an antithrombotic. When a patient is on Eliquis long-term, it can be a coding conundrum. As published in Coding Clinic, Second Quarter 2022, ICD-10-CM classifies Eliquis as an anticoagulant medication. Therefore, if long-term use of Eliquis is documented in the record, assign code Z79.01 (The long-term (current) use of anticoagulants).
This condition is commonly documented along with chronic kidney disease (CKD). MBD is a broad term used to describe a group of bone disorders of bone strength usually caused by mineral abnormalities such as calcium, phosphorus, vitamin D, or magnesium. As published in Coding Clinic, Second Quarter 2022, when MBD is a component of another disease process, only the underlying condition (e.g., secondary hyperparathyroidism or renal osteodystrophy) is coded. If no underlying condition is documented, code the appropriate code from subcategory M89.8X-.
Jeanie Heck, our Director of Education, wraps up our E/M Hot Topic series for 2021 discussing the new 2022 Principal Care Management Services codes. In 2022, we will have three general categories of Care Management in our E/M section. The new PCM codes allow providers, qualified health care practitioners, and clinical staff to report a code(s) for the management of a single chronic condition.
For additional information about E/M Guideline Updates education, contact us.
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