PLACEHOLDERS AND 7TH DIGIT CODE ASSIGNMENTS

Slides:



Advertisements
Similar presentations
Natural Language Processing An innovative, disruptive technology for ICD-10 Coding, Secondary Data Use, and EHR Data Capture James M. Maisel, M.D. Chairman,
Advertisements

NLP as a Data Integration Tool for Your CIO James M. Maisel, MD Chairman, ZyDoc
Chapter 7 ICD-10 Codes.
Musculoskeletal System
2010 UBO/UBU Conference Title: ICD-10-CM General Guidelines Session: T
1. Today’s Panelists: Sandy Giangreco, Sandy Giangreco, RHIT, CCS, RCC, CPC, CPC-H, CPC-I, PCS, AHIMA Approved ICD-10 CM/PCS Trainer CHIMA ICD-10 Task.
CAC with Natural Language Processing (NLP) Solves ICD-10 Conundrum James M. Maisel, MD Chairman, ZyDoc
ICD-10 Getting There….. Plastic Surgery.
INTRODUCTION TO ICD-9-CM
Moving Toward Compliance October 2014 Community Care Network of Virginia, Inc.
The Transition to ICD-10 November 8, 2013 Dickon Chan Health Insurance Specialist Centers for Medicare & Medicaid Services 1.
ICD-10 It Takes a Village! Presented by: Shawn Philabaum, Clinical & Revenue Cycle Specialist Kelsey Damroze, Software Education & Implementation.
My Vision Express presents An introduction to the new coding system ICD-10 Ready?
Guidelines Most Significantly Affected Under ICD-10-CM
Garnet Career Center Maggie McCabe, PAHM, CPC, CPC-H, CPC-P, CPC-I, CMOM, CMC January 30, 2015 Overview of ICD-10-CM Webinar Sponsored by WVHIMSS.
Colorado Trauma Network/ Colorado Trauma Registry Health and Safety Data Services Coding Injuries in ICD10CM 10/1/2014.
The Montana Hospital Discharge Data System MHDDS Users Group Meeting Mar 2014.
ICD-10 ORIENTATION IN POST ACUTE CARE Rhonda Anderson, RHIA Anderson Health Information Systems, Inc.
Presented by: Andrea Romero April 12, 2012 HFMA/NMHIMA Spring Conference.
Introduction to ICD-10-CM 2015
ICD-10-CM.
1 UHS, Inc. ICD-10-CM/PCS Physician Education Orthopaedics.
Medical Coding II Seminar 6.
ICD-10-CM: PRL Training Session 3 Practice Resources, LLC
ICD-10-CM OVERVIEW OF UPCOMING DOCUMENTATION COMPONENTS OF ICD-10-CM.
Barbara Parker, CMA (AAMA), CPC, CCS-P.  ICD-10 Implementation  Format  Differences between ICD-9 and ICD-10  Resources.
CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 15-21)
ICD-10-CM Made Simple Prepared Geanetta Agbona CPC, CPC-I, CBCS AHIMA Approved ICD-10-CM Trainer/AAPC Physician Educator 1.
Case Report Jonathan Kneib PGY-2.  19 yo male wth no significant PMH comes in to ED s/p texting while on a pogo stick and sustaining a fall. Patient.
Main Objective The impact of the conversion to The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Create an.
Medicare Documentation & ICD-9-CM Coding Presented by Rhonda Anderson, RHIA President Anderson Health Information Systems, Inc
Requirements Official coding guidelines require the use of V codes for aftercare and specify that applicable aftercare V-codes are to be used for conditions.
The Transition to What you need to know for Orthopedics Date | Presenter Information.
Fractures Treatment and Complications
0 Presentation to: 5 August 2015 Presented by: Heather Bond, Medicaid Assistant Chief, Regulatory Compliance Exciting ICD-10 Presentation.
ICD10 Are You Prepared? Presented by Cheri Welk, RHIT Manager, Physician Billing April 6, 2013.
Copyright © 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 1 CHAPTER 7 CHAPTER-SPECIFIC GUIDELINES.
Orthopaedic ICD-10 CM Training. ICD-10-CM will be valid for dates of service on or after October 1, 2015 – Outpatient dates of service of October 1, 2015.
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
ICD-10 CM Overview with Concentration on Neoplasms and Fracture
powered by: 1. Documentation for ICD-10 Moving From Here to There Presented by Betty B. Bibbins, MD, BSN, CHC, C-CDI, CPEHR, CPHIT President.
ICD-10 – What Radiologists Need to Know Stephanie Hatton, RCC California Medical Business Services Arcadia, California.
Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS CC/MCC Lists: A comparison of ICD-9-CM to ICD-10-CM.
International Classification of Diseases, Tenth Revision, Clinical Modification 1.
Diseases of the Musculoskeletal System and Connective Tissue M00 – M50
Clinical Terminology and One Touch Coding for EPIC or Other EHR
Home Town Health - August
ICD-10-CM Preview Presented by Regina Glenn, PhD., RHIA, CCS Davenport University.
CHAPTER 9 USING ICD-10-CM.
Božović A, Grbić R, Milović D, Elek Z, Petrović D, Jakšić L, Radojević G. Treatment of tibial shaft fractures with external fixation type Mitković – Analysis.
Transition to Value Based Payment
Diagnosis Coding.
Submuscular Bridge Plating for Pediatric Femur Fractures
ICD-9-CM, ICD-10-CM, and ICD-10-PCS Coding Systems
Category II & Category III
2018 ICD-10-CM UPDATES JULIE BOS, CPC, CPB, CPPM.
CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)
Mary Jo Bowie MS, BS, AAS, RHIA, RHIT
ICD 10 Guidelines on External Cause Codes
Mary Jo Bowie MS, BS, AAS, RHIA, RHIT
CMS PROPOSED E/M Changes
Mary Jo Bowie MS, BS, AAS, RHIA, RHIT
© 2018 American Health Information Management Association ICD-10-CM Organization and Format ICD-10-CM code books differ depending on publisher of the book.
Comprehensive Medical Assisting, 3rd Ed Unit Three: Managing the Finances in the Practice Chapter 15 – Outpatient Procedural Coding.
Drug screen coding and billing
Comprehensive Medical Assisting, 3rd Ed Unit Three: Managing the Finances in the Practice Chapter 14 - Diagnostic Coding.
INPATIENT vs OUTPATIENT CODING
ICD-10-CM Chapter Review 15-21
Presentation transcript:

PLACEHOLDERS AND 7TH DIGIT CODE ASSIGNMENTS Greater Orlando AAPC Chapter April 17, 2018

USE OF PLACEHOLDER “X” PLACEHOLDER “X” The letter "X” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The "x” also allows for future expansion of the codes. When reporting ICD-10-CM codes, coders must add a placeholder so the seventh character is in the correct position. Example: Fracture, Nose, Nasal Bones S02.2 Requires 7th digit of “A” Therefore, 5th digit and 6th digit are required. Since there are no 5th/6th digits for S02.2, placeholder “X” is assigned to both digits Code needs to look like: S02.2_ _ A  S02.2XXA Fracture of nasal bones, initial encounter for closed fracture  

USE OF PLACEHOLDER “X” (continued) Example: Injury, Crush of Right Ankle S97.01 Requires 7th digit of “A” Therefore, 6th digit is required. Since there is no valid 6th digit for S97.01, placeholder “X” is assigned to 6th digit. Code needs to look like: S97.01_A S97.01XA Crushing injury of right ankle, initial encounter

7TH Character for Injuries and Fracture Care In Chapter 19 and Chapter 20, the seventh character provides specific information about the episode of care (e.g., initial episode, subsequent episode, and sequelae). A, initial encounter: Used while the patient is receiving active treatment for the condition. Some examples include surgical treatment, ED encounter, and evaluation and continuing treatment by the same or a different physician. D, subsequent encounter: Used after the patient received active treatment for the condition and is receiving routine care during the healing or recovery phase. Examples of subsequent care include cast change or removal, an x-ray to check healing status of a fracture, removal of external or internal fixation device, medication adjustment, and other aftercare and follow-up visits following treatment of the injury or condition. S, sequelae: Used for complications or conditions that arise as a direct result of a condition, such as a scar formation caused by a burn.

Fracture Extensions Categories for traumatic fractures have more available options for the seventh character. Assignment of the seventh character is based on whether the patient is undergoing active treatment and not whether the provider is seeing the patient for the first time, according to the Official Guidelines for Coding and Reporting. When used with fracture codes, it provides additional details, such as whether the fracture is closed or open (with type), whether there is routine or delayed healing, and whether the fracture was a nonunion or malunion. Category S42 requires more specifics on the state of the fracture (Fracture of shoulder and upper arm): A - Initial encounter for closed fracture B - Initial encounter for open fracture D - Subsequent encounter for fracture with routine healing G - Subsequent encounter for fracture with delayed healing K - Subsequent encounter for fracture with nonunion P - Subsequent encounter for fracture with malunion S - Sequela

Extremity Fractures – Gustilo Classifications When coding extremities, fractures are based on Gustilo open fracture classifications. For example, this would apply when reporting codes for fractures in Category S52 (Fracture of the forearm), S72 (Fracture of Femur) and S82 (Fracture of Lower Leg).  The following extensions are to be used to ensure a complete code: B - Initial encounter for open fracture type I or II C - Initial encounter for open fracture type IIIA, IIIB, or IIIC E - Subsequent encounter for open fracture type I or II with routine healing F - Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing H - Subsequent encounter for open fracture type I or II with delayed healing J - Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing M - Subsequent encounter for open fracture type I or II with nonunion N - Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion Q - Subsequent encounter for open fracture type I or II with malunion R - Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion  

Further Information from Coding Clinic Additional Information Available from: Coding Clinic, 1st Quarter, 2015, Page 3 7th character "A", initial encounter is used while the patient is receiving active treatment for the condition. Examples of active treatment are: surgical treatment, emergency department encounter, and evaluation and continuing treatment by the same or a different physician. 7th character "D" subsequent encounter is used for encounters after the patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase. Examples of subsequent care are: cast change or removal, an x-ray to check healing status of fracture, removal of external or internal fixation device, medication adjustment, other aftercare and follow up visits following treatment of the injury or condition

Marsha S. Diamond, CPC, COC, CPMA, CCS, AAPC Fellow QUESTIONS/COMMENTS?? CONTACT INFORMATION: Marsha S. Diamond, CPC, COC, CPMA, CCS, AAPC Fellow (407) 230-9000 md@coeh.com