Advanced Search

OASIS Alert

Coding:

Follow These Tips To Conquer Coding Changes

Published on Sun Jun 01, 2003

If you wait until fall to think about ICD-9 changes for 2004, you'll be scrambling to catch up.

ICD-9 codes seem frustratingly complex to many home health agencies, and that's because they really weren't created with 485's, billing and outcome-based quality improvement in mind.

The codes actually are a statistical classification system used worldwide to track morbidity and mortality, explained Prinny Rose Abraham in a recent Coding Institute teleconference. "It's like using a screwdriver to hammer a nail it works but it's not very efficient," quipped Abraham, a coding expert with Minneapolis-based HIQM Consulting.

The system changes all the time, as different groups request new codes to identify diagnoses more specifically, she noted. Agencies should expect to see changes every October 1st like clockwork. One key to accurate coding is keeping up-to-date with these changes.

Abraham provided listeners with these tips to stay on top of coding:

  • Keep up-to-date coding books available. "Over the last three years there have been over 1,000 coding changes," Abraham said. Put ordering next fall's coding book on your summer "to do" list, so you're not scrambling to find one October 1st.

  • Add new codes to HAVEN software. Update your software using either the HAVEN new release if you're a registered user or the patch available on the OASIS Web site at http://cms.hhs.gov/oasis. Or press your software provider for timely updates. You may need to update servers, desktop and laptop computers, Abraham warned.

  • Find out what codes have changed. Tables listing new and changed codes are at http://cms.hhs.gov/medlearn/icd9code.asp. Some of the new codes agencies will appreciate are an index entry for accelerated angina, "poorly controlled" as a non-essential modifier for the index entries for diabetes and an index entry for severe obesity, Abraham observed.

  • Always verify the code. Once you've looked up a code in the index, don't forget to go from the index to the tabular part of your coding book to verify it. That's the only way to see the inclusions and exclusions lists the instructional statements that help you assign codes correctly.

  • Cross-referencing is essential for correct coding. Imagine you're back in school and think of coding as a giant outline but one that's always changing.

    • Other Articles in this issue of

    OASIS Alert

    View All