HCC Blog by Caridad

The AFP Community Blog: Depression treatment: the evidence base from a pri... : - Jennifer Middleton, MD, MPH Most patients with depression  receive treatment solely from a primary care physician . Family physicians ha...

Diabetes “Buddy” codes The ICD-9-CM code for diabetes is assigned to category 250 Diabetes Mellitus.   The fourth digit is used to indicate the presence of a manifestations or complications identified due to diabetes. Consider the following in the documentation before assigning a code: 1. Type of diabetes the patient has. 2. Is the diabetes is controlled or uncontrolled? 3. Are there manifestations or complications? If so, what are they? Coding guidelines require two ICD-9 codes be used when coding diabetes and its manifestation.   If the physician just lists 250.40, then it is an incomplete diagnosis. They would need the second “buddy” code to completely document the patient’s condition.   The linking words of “due to” in the medical record are important as well. The following codes are used to indicate diabetes with manifestations.   The fifth digit determines the type of diabetes and whether it is uncontrolled or not stated as uncontrolled. 25...

From the Centers for Medicare and Medicaid Services (CMS) YouTube channel, CMSHHSgov, the following videos on ICD-10-CM are available from their  CMS main page on YouTube : Introduction to ICD-10 Coding  2 minutes ICD-10 Coding and Diabetes  2 minutes Coding for ICD-10-CM: More of the Basics 12/02/14   36 minutes A free on line version of  ICD-10-CM  is available from the Centers for Disease Control and Prevention , CDC. #HCC #ICD-10   Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.   The information presented herein is for general informational purposes only. And is ...

CMS ICD-10 Resources The Centers for Medicare & Medicaid Services (CMS) offers resources to help the health care community prepare for the October 1, 2015, ICD-10 transition. No matter where you are in the process, CMS has resources to help you prepare. ICD-10 Basics Basic resources are a great place to start if you are looking for the background and benefits of the ICD-10 transition. These resources include overviews tailored by audience, including small and rural practices, payers, and non-covered entities. The ICD-10 Transition: An Introduction ICD-10 Basics for Medical Practices ICD-10 Basics for Small and Rural Practices ICD-10 Basics for Payers The ICD-10 Transition: Focus on Non-Covered Entities Communicating About ICD-10 Communication between health care providers, software vendors, clearinghouses, and billing services is vital to a successful transition. Learn how to get the conversation started with these resources: T...

For Payment Year (PY) 2014, Centers for Medicare and Medicaid (CMS) used a blended model when calculating risk score payments to health plans by taking 25% of the 2013 HCC Model 12 and 75% of the 2014 HCC Model 22. (HCC = Hierarchical Condition Coding)     Although it was expected that CMS would fully phase in Model 22 by PY2015, CMS announced in the Final Call Letter on April 7, 2014 that the HCC blended model would continue.   For PY2015, CMS will use a blended risk score for each member by taking 67% of the 2013 HCC Model 12 and 33% of the 2014 HCC Model 22 each appropriately normalized.   http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/downloads/Announcement2015.pdf     #HCC   Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and...

Major depressive disorder According to the American Psychiatric Association, major depressive disorder can be seen in patients who have suffered a depressive episode lasting at least two weeks, as manifested by at least five of the following symptoms: depressed mood, loss of interest or pleasure in most or all activities, insomnia or hypersomnia, change in appetite or weight, psychomotor retardation or agitation, low energy, poor concentration, thoughts of worthlessness or guilt, and recurrent thoughts about death or suicidal ideation. Major depression is highly recurrent, with recurrent episodes occurring in 50% or more of patients. Remission and recovery from major depression Whether or not a patient is being treated for depression (e.g., counseling and/or medication), remission can be defined as a level of depressive symptoms basically indistinguishable from that in someone who has never been depressed. When reporting history of major depressive disorder, instead of coding V1...

The Centers for Medicare and Medicaid (CMS) offers web-based training courses that allow you to view and enroll in courses that are available to take online. Search Google for  ' cms.meridianksi.com' or try this link - CMS Web Based Training Register to create a free account. A learning catalog is available at: Medicare Learning Network-Autumn2014 Catalog It containts the latest edition of the MLN Catalog are listed all the products and services currently available through the CMS Medicare Learning Network®.