View the ICD-9 code's corresponding Diagnosis Related Groups (DRGs). In a click, verify the DRG, its IPPS allowable, length of stay, and more. Protect your facility's payments by subscribing to DRG Coder.
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If I am reading your question correctly, I would have 1 question and 1 recommendation.
1. Is the postoperative chest x-ray being performed only to "confirm placement" of the pacemaker ... [ Read More ]
If you are the gyn performing this visit with a decision for sterilization, I don't believe any of these codes should be submitted on your claim.
The ORDER for PST covid swab should have Z01.812 prima... [ Read More ]
Patient is seen for counseling discussion, desires permanent sterilization. After the counseling patient chose surgical permanent contraception; laparoscopic salpingectomy. Procedure/surgical plannin... [ Read More ]
Medical necessity edits are based on payer reimbursement policies (usually Medicare LCDs) so you would need to take a look at your particular payer’s published policies to see whether or not the edi... [ Read More ]
Lab order diagnoses codes are Z01.818 and M16.11 - only labs were charged and our guidelines are to change the Z01.818 to Z01.812 in this situation; however, when I do that, the Hgb fails medical nece... [ Read More ]
[QUOTE="DGgirll20, post: 501039, member: 693252"]
For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of ... [ Read More ]
MCR does not reimburse for A4550, for us here in NY they do not even pass through EDI. Also your DX codes are incorrect. DX M54.2 should be M54.12 for Cervical Radiculopathy and DX code M47.812 will n... [ Read More ]
My Ophthalmologists use diagnosis codes: H25.811 and H25.812 instead of the bilateral code. I have not been able to find guidelines that state they have to use the bilateral diagnosis code instead of... [ Read More ]
Is there a specific guideline that instructs us to use a bilateral diagnosis code of H25.813 instead of using the diagnosis codes H25.811 and H25.812? I know there is a guideline for glaucoma coding ... [ Read More ]
"Per LCD or NCD guidelines, procedure code 64490 has not met the associated Code-to-Code relationship criteria for CMS ID(s) L34892"
This is the denial received for an AARP Medicare Complete plan wher... [ Read More ]
Code for quality of care, not just reimbursement. According to the Agency for Healthcare Research and Quality (AHRQ), over 2.5 million people in the United States are affected by pressure ulcers each year, with the total annual cost for treatment [...]
Question: How will the new ICD-10-CM codes for childhood obesity, which became effective October 1, 2024, improve diagnosis and treatment for children and adolescents? What are some of those codes? North Carolina Subscriber Answer: Obesity is a complex, chronic condition [...]
Question: I’ve been using code F50.8- pretty regularly for years, but I tried to use it on a claim recently and it was denied. What’s going on? AAPC Forum Participant Answer: When ICD-10-CM codes were updated in 2024, that code [...]
Go beyond documentation to help end the stigmatization of your obese patients. On Oct. 1, 2024, ICD-10-CM introduced a new option to code obesity by class. But why were these codes needed? For example, prior to the release of the [...]
Specify obesity classes with new codes. With more than 250 new diagnosis codes, the 2025 ICD-10 code set affects almost every category. On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) updated the code set, and as [...]
See how obesity coding is getting more precise. With more than 250 new diagnosis codes, the 2025 ICD-10-CM code set affects almost every category. On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will update the code [...]
Also, synovitis/tenosynovitis combo code expands. ICD-10-CM has released its list of new, revised, and deleted codes for 2025. Impact: Code sets have been expanded for type 1 diabetes and several eating disorders, among others. You’ll want to know the changes [...]
Also, synovitis/tenosynovitis combo code expands. ICD-10 has released its list of new, revised, and deleted codes for 2025. Impact: Code sets have been expanded for type 1 diabetes and several eating disorders, among others. You’ll want to know the changes [...]
Prep now to hit the ground running on Oct. 1, 2024. The Centers for Medicare & Medicaid Services (CMS) unveiled the 2025 ICD-10 changes on July 9, 2024. The changes include 252 codes added, 36 existing codes deleted, and 13 [...]
Also, synovitis/tenosynovitis combo code expands. ICD-10 has released its list of new, revised, and deleted codes for 2025. Impact: Code sets have been expanded for type 1 diabetes and several eating disorders, among others. You’ll want to know the changes [...]
Increase Diagnoses Coding Compliance with Medicare Transmittal and Manuals directives right at code level.