HCC Blog by Caridad

Acute embolism and thrombosis of unspecified deep veins of lower extremity ICD-9    453.40 Acute venous embolism & thrombosis of unspecified deep vessels of lower extremity ICD-10 I82.40 Acute embolism and thrombosis of unspecified deep veins of                I82.401 … right lower extremity                I82.402 …left lower extremity                I82.403 …bilateral                I82.409 …unspecified lower extremity

Diverticular disease of intestine ICD-9    562.11 Diverticulitis of colon ICD-10  K57.2   Diverticulitis of large intestine with perforation and abscess K57.20 … large intestine with perforation and abscess without bleeding K57.32 … large intestine without perforation or abscess without bleeding K57.40 …both small and large intestine with perforation and abscess without bleeding K57.52 … both small and large intestine without perforation or abscess without bleeding K57.80 … of intestine, part unspecified, with perforation and abscess without bleeding K57.92 … of intestine, part unspecified, without perforation or abscess without bleeding

Five updated Diabetes Mellitus categories to reflect the current clinical classification and manifestations: E08 Diabetes Mellitus due to an underlying condition E09 Drug or chemical induced diabetes mellitus E10 Type 1 diabetes mellitus E11 Type 2 diabetes mellitus E13 Other specified diabetes mellitus Note: No longer use controlled and uncontrolled. Now classifies inadequately controlled, out of control, and poorly controlled diabetes mellitus by type with hyperglycemia.

I attended the 2014 California Healthcare Conference presented by MCHC at the Anaheim Convention Center. It was my first chance to attend a coding conference. It was an opportunity to network with other coders and meet new ones and learn the latest coding news. Some of the workshops included suggestions on how to improve ICD-10 documentation by working with providers;   the importance of compliance manuals,  HIPPA and fraud, waste and abuse was covered; being proactive in audit plans  for coding, contracts and patient care.  I also took “Advanced Human Anatomy in Coding” and musculoskeletal system which will be an integral part of the detail needed for ICD-10. “Ethics for coders” was a great refresher as we advocate for our physicians to get paid and we stay away from illegal behavior or practices.  There was a hands-on auditing session which is always a great refresher on what to look for in documentation. Many of the workshops were presented by Annie...

This blog covers general documentation tips for patient charts. Physicians should always document the status of each diagnosis using descriptive words such as:  stable on meds, controlled by diet, improving, acute, chronic, worsening, etc. Be sure to include a treatment plan using descriptive words such as: continue, increase, decrease, "name of medication", refer to ______.   Using a brief statement for each diagnosis would be optimal as well as referring to medication name and the reason the patient is taking it. History of means the condition no longer exists. There are appropriate codes to indicate this information. Medical Assistants can great assist the physician by checking the last time the patient had their lab work completed, as well as documenting the patients weight and making sure the BMI is calculated.  BMI is currently an HCC code, we call it a buddy code as two codes are needed.  Principles of Documentation Include patient n...

Atherosclerosis of native artery of the extremities Use additional code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92):   ICD-9    440.20   Atherosclerosis native artery extremities unspecified ICD-10  I70.20   Unspecified atherosclerosis of native arteries of extremities… I70.201 ….. right leg I70.202 ….. left leg I70.203 ….. bilateral legs I70.208 ….. other extremity I70.209 ….. unspecified extremity