Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Clinical validation could upend your current risk adjustment policies. The rise of risk adjustment-based managed care programs in the past 15 years within Medicare, Medicaid, and Affordable Care Act (ACA) plans has led to remarkably good news: There has been a significant improvement in the accuracy of the diagnosis codes abstracted from medical documentation among […]
The post Capture the Complete Clinical Picture With Precision appeared first on AAPC Knowledge Center.
I have found the below documentation from the 2010 ICD-9 Coding Clinic that states if a pacemaker is placed to treat the sick sinus syndrome, that only the pacemaker code should be used. I am not able to find any documentation that shows this has changed. Would this only occur during the interrogation? Would you be able to bill both codes out at a regular follow-up visit?
Would a complete heart block fall into the same situation? I am not able to find any official documentation to confirm if the complete heart block and pacemaker codes can be used together.
Not billing the complete heart block would affect the patient’s risk score just as with the sick sinus syndrome.
Any and all help is greatly appreciated!
Thank you – Missy
ICD-9-CM Coding Clinic, Third Quarter 2010 Pages: 9-10 Effective with discharges: October 1, 2010
Question:
Coding Clinic, Fifth Issue 1993, page 12, advised that when sick sinus syndrome (SSS) is controlled by a pacemaker, no code assignment is required if no attention or treatment is provided to the condition or the device. However, we are seeing records where the patient is admitted for an unrelated condition, but during the stay the physician does an interrogation of the pacemaker. Is it appropriate to assign a code for sick sinus syndrome, as a chronic condition, when a patient has a previously placed pacemaker and it is interrogated during the hospitalization?
Answer:
Assign code V53.31, Fitting and adjustment of other device, Cardiac device, cardiac pacemaker, as an additional code assignment. A code is not assigned for sick sinus syndrome when it is being controlled by the pacemaker and no problems are detected during the check. Interrogation is a routine check, which is done via computer to assess pacemaker function. The pacemaker is routinely evaluated to ensure the device is programmed accurately as well as to assess battery and lead function. Pacemaker settings may be reprogrammed, if required. Interrogation of the device can be done in the inpatient setting or in the office setting.
Code 89.45, Artificial pacemaker rate check, may be assigned for the procedure.
Thanks in advance….
excision and application of wound vac 6×5
ostectomy of the 4th and 5th metatarsal and cuboid
excision and intermediate closure 4cm lateral foot
anesthesia: MAC
diagnosis: wound to the right foot
Thanks for the help!
For instance I see: LV diastolic function could not be assessed due to the presence of atrial fibrillation during the study.
since the provider tried to get a reading and could not are they able to get credit for that or is this a modifier 52 situation?
thank you!!
There are 14 possible systems to be reviewed. Does this statement mean that to get credit for a complete ROS you have to individually document the 10 systems and then all remaining (4) can be documented as "all other systems negative)?
I have always allowed my providers to document the pertinent +/- (however many that may be) and then state "all other systems negative" to get credit for a complete ROS. A coder on our team is reading the guidelines differently so we thought we’d see how others interpret this.
Thank you,