Uncommon diabetes complications and risk adjustment.
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Tag Archives: Complications
Surgical Complications Don’t Have to Be Complicated in New York City
AAPC’s Regional Conference in New York City (Aug. 19-21) is the place to be for everyone on the revenue management side of healthcare; it provides the latest education, networking, vendors, and opportunities to keep you ahead of other healthcare business professionals. If you are a medical coder, biller, or auditor you’ll find it’s a treasure trove of career resources ― […]
The post Surgical Complications Don’t Have to Be Complicated in New York City appeared first on AAPC Knowledge Center.
Global OB -Complications or if at higher risk
We have some colleagues debating on this. If most of your patients are seen for complications or are at higher risk and most of their visits are billed to insurance with an E/M (some cover these and don’t require you to bill out at time of delivery) how are you handling global? Since some of these patients have zero routine visits at the time they deliver because their complications or high risk visits were billed and paid are you splitting the global since there are no routine visits? ex 59410, 59515 etc… or are you counting the high risk visits as prenatal even though they were paid to equal the 10-13 visits allowed by most carriers.
Global OB -Complications or if at higher risk
I also posted this in coding but i’m curious how billing handles this we have some colleagues who have different opinions on this. If most of your patients are seen for complications or are at higher risk and most of their visits are billed to insurance with an E/M (some cover these and don’t require you to bill out at time of delivery) how are you handling global? Since some of these patients have zero routine visits at the time they deliver because their complications or high risk visits were billed and paid are you splitting the global since there are no routine visits? ex 59410, 59515 etc… or are you counting the high risk visits as prenatal even though they were paid to equal the 10-13 visits allowed by most carriers.
Risk Adjustment Coding- DM and complications coding.
We need clarification when coding from the following examples:
Example #1
Provider’s documentation states:
DM without complications
Hypertension with CKD III
Example #1
Provider’s documentation states:
DM without complications
Hypertension with CKD III
Coding:
E11.9, I12.9, N18.3
or we should code:
E11.22, I12.9, N18.3
Example #2
Provider’s documentation states:
DM
Hypertension with CKD III
Coding:
E11.22, I12.9, N18.3
Coded as guidelines stating.
Example #3
Provider’s documentation states:
DM without complications
Polyneuropathy
Coding:
E11.42
or we should code:
E11.9, G62.9
Example #4
Provider’s documentation states:
DM
Polyneuropathy
Coding:
E11.42
Coded as guideline stating.
Guidelines:
ICD10-CM presumes cause and effect linkage between DM and certain conditions unless the physician specifically indicates the conditions are not related. Conditions that appear in the index as indented subterms under the various types of "diabetes, with" are coded as diabetic complications, even in the absence of the physician documentation explicitly linking them, unless the documentation clearly indicates these conditions are not caused by diabetes for example, by stating:
Actual nondiabetes related cause
Cause is not diabetes
Diabetes is without complications
Cause is unknown.
Any help is much appreciated.
Thank you.
NEED HELP Quick!g donor complications from transplant procedure
I have researched until I blue in the face and no definitive answer which I need! If a living donor is having complications from the transplant surgery how would code the complications? Would it be T86.19 other complication of kidney transplant or would it be T81.9XXA for unspecified complication of procedure? My initial thought was that the T86.19 was recipient specific but then I was thinking if we bill all charges for the donor under the recipient using the Q3 modifier that we would use the T86.19 showing it was a complication from the transplant surgery and the Q3 is what directs them to know that the donor is having the complications but I may be overthinking it. I just need a definitive answer. Any help or thoughts would be much appreciated!
Final post op visit with complications
Can I please have your opinion…….
Patient underwent surgery and has now presented to the office for his final post operative visit. He has now developed cellulitis around his incision and the need for hospital admission for IV antibiotics, etc.
Since the patient in still within his global period and this appears to be a related complication of his surgery, is then anything other than a post operative visit you can bill?
Thank you!
DM without complications vs. with a complication
Hello!
E11.9 (Type 2 dm without complications) should not be coded with E11.41 (Type 2 DM with diabetic mononeuropathy) correct? It is my understanding you should not code without complication and complications together.
Thanks!
Coding Quiz Question for Succss in COding for Orthopedic Complications 3/2018
Question # 10 of the coding quiz asks "Which ICD-10 code is reported for the sequela encounter for a 4-part fracture of the surgical neck of the left humerus? Correct answer is D. S42.432S the rationale being the 7th character place holder S is for sequela. The code description from ICD-10 for S42.432S reads "Displaced fracture (avulsion) of lateral epicondyle of left humerus. The code description for S42.242S, which seems to describe the condition exactly reads "4-part fracture of surgical neck of left humerus" was not an option. Can you please explain why?
Post-Operative Complications in the Global Period
Is the caring for, and treatment of post-operative complications in the global period coded and billable? To answer this question, You first must know who the third-party payer is because different payers have different rules. What’s the Global Issue? Medicare says they will not pay for any care for post-operative complications or exacerbations in the global […]
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