ICD-10 Articles : Medical Billing Blog

All ICD-10 Articles Added to Our Blog

This is the archive containing links to all ICD-10 articles written in our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

How to Choose Between Modifiers 25 and 57

When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains

By: Melissa Clark, CCS-P, RT - CEO
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You Should Worry about Medical Coding Guidelines Changing

Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to physicians, particularly those who derive much of their income from office visits. CHANGE IS OVERDUE It has been 20 years since the 1997 E&M guidelines were promulgated. They were confusing to most physicians then and remain confusing today. One study from the Journal of Family Practice showed that physicians are accurate in their E&M coding only 55 percent of the time, yet Mitchell King, MD provided a fascinating follow-up investigation in the Archives of Internal Medicine that showed certified coding

By: Melissa Clark, CCS-P, RT - CEO
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2018 ICD-10-PCS Code Changes

The U.S. Department of Health & Human Services (HHS) has released the code changes for ICD-10-PCS coding system. ICD-10-PCS codes were adopted under HIPAA for hospital inpatient healthcare settings to use for reporting procedures. Their guidelines help healthcare providers and coders to accurately identify procedures to be reported on healthcare claims. The 2018 updates will reflect services from Oct. 1, 2017 through Sept. 30, 2018, so be sure to update your medical records to account for the changes. There were 75,789 codes in 2017. In 2018, the number jumps to 78,705…   Continue reading this article  

By: Melissa Clark, CCS-P, RT - CEO
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Capitol Hill is paying a lot of attention to ICD-10…

“Capitol Hill is paying a lot of attention to ICD-10 implementation” is a great article by Carl Natale on ICD-10 Watch that talks about a big week in ICD-10 implementation…   Excerpt: “The U.S. House Energy & Commerce Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), has scheduled a hearing on “Examining ICD-10 Implementation” for 10:15 a.m. Wednesday. There isn’t a list of witnesses yet. But expect representatives from Centers for Medicare and Medicaid Services (CMS), American Health Information Management Association (AHIMA) and American Medical Association (AMA) at least.   There are plans to livestream it at http://energycommerce.house.gov/.   This comes a day after the Coalition for ICD-10 sponsors

Mentioned By: Melissa Clark, CCS-P, RT - President and CEO
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Is Your Small Practice Ready for ICD-10?

It’s 193 days to ICD-10 and to be honest, that’s not much time! It’s time to get your practice ready to use ICD-10, but where do you begin? There’s no question it can be overwhelming! Here’s the steps we recommend to any Providers that ask. Let’s get started. Put One Person in Charge First things first, you need to assign the task of overseeing ICD-10 to someone on your staff. It doesn’t matter whether that person is the biller, a coder, the office manager, or someone else. Their goal is to lead the process, ensure things are on task and on target, and to oversee the details.   Develop a

By: Kathryn Etienne, CCS-P, RT - DOO
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7 Benefits of Outsourcing Your Medical Billing with ICD-10

It can be difficult deciding whether to outsource your medical billing or not. With ICD-10 coming in October, There are many benefits of outsourcing your revenue cycle functions. Let’s take a look at 7 of those benefits.   #1 Economy of Scale A billing service will distribute their expenses through their complete client base, which provide an economy of scale. They are able to operate with lowers costs than what a single practice can and those savings are passed on to their clients, making them very competitive. A billing service is able to afford to hire top-notch staff so you are able to pay less and get more.   #2

By: Melissa Clark, CCS-P, RT - CEO
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Is ICD-10 Going to Provoke a Level of Healthcare Insanity?

Is ICD-10 going to provoke a level of healthcare insanity? The opinions of a coder. ICD-10 or International Classification of Diseases is designed to create a system where there is compatibility throughout the nation relating to data collection, processing and classification of disease, as well as presenting mortality statistics. The ICD-9 has been revised and as a result, we now have the ICD-10, a whopping three volumes of alphanumeric categories. Some chapters have been changed and rearranged and some conditions have been regrouped from ICD-9. In fact, there is almost double the number of categories from ICD-9 to ICD-10. ICD-10 opponents say that ICD-10 has gone too far, that it

By: Melissa Clark, CCS-P, RT - CEO
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ICD-10 for Substance Abuse & Mental Health Providers

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a new fact sheet designed to help mental health and substance abuse service providers make the transition to the new International Classification of Diseases, 10th Edition (ICD-10) code sets. ICD-10 will affect all diagnosis and inpatient procedure coding for everyone involved in mental health and substance abuse healthcare under HIPAA. However the change to ICD-10 does not affect CPT coding for outpatient procedures. All services provided for either substance use or mental disorders are subject to HIPAA standards; therefore, all mental health and substance abuse providers must shift to ICD-10 once it becomes effective on October 1st. SAMHSA’s new

By: Melissa Clark, CCS-P, RT - CEO
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