Cardio Case — Surgical Coding Series: WHP Coding Conundrums

As most medical practices are aware, not all cases are easy to navigate using the latest medical standards. The information below highlights a complicated cardio surgical case with an detailed cardio case, correct CPT and ICD-10 codes. Do you have a complicated surgery case need help with coding? Welter Healthcare Partners would love to help! please upload the operative note by clicking on the link below. Remember to remove ALL patient protected health information and organization identifiers. Welter Healthcare Partners will not use any medical records submitted in which PHI is not removed and protected. Click Here To Submit Redacted Surgery Case Study. Click Here To Submit Redacted Surgery Case Studynn


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  1. Left heart catheterization.
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  3. Left ventricular angiography.
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  5. Bilateral selective coronary artery angiography.
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  7. Coronary artery bypass graft angiography x3.
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  9. Coronary artery disease.
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nINDICATIONS:n

Prop for tricuspid valve surgery.

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Click Here to View Full Case

n nnCorrect CPT and ICD-10 Codes with modifiers and units:nn93459 (26 modifier) – Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiographynnI25.10 – Atherosclerotic heart disease of native coronary artery without angina pectorisnI25.82 – Chronic total occlusion of coronary arterynI07.1 – Rheumatic tricuspid insufficiency

Industry Hot Buttons — MACRA / MIPS Update

Industry Hot Buttons — MACRA / MIPS UpdateWith the implementation of QPP, the deadline for submitting 2017 performance data is approaching fast! Eligible providers can submit performance data for dates of service starting on January 1, 2017 – October 2, 2017. Data submission to CMS must be done by March 31, 2018.nnIf your practice chooses not to submit data for 2017 reporting, then you will receive a negative 4% payment adjustment. If your practice submits the minimum data required for 2017 reporting, you can avoid the negative adjustment and receive a neutral adjustment. If your practice submits partial data required for 2017, which is 90 days of 2017 data, you will receive either a neutral or positive adjustment depending on your performance. If your practice submits a full year of data for 2017, you may receive up to a 4% positive payment adjustment, again depending on your performance. The first payment adjustments based on performance go into effect on January 1, 2019.n

CLICK HERE TO SUBMIT A CASE STUDY TO THE SURGERY CODING SERIES!

2018 ICD-10 Updates

2018 ICD-10 Updates2018 ICD-10 updates will soon go into effect on October 1st. These changes will impact encounters for dates of service October 1, 2017 through September 30, 2018. It is imperative that your organization has up-to-date coding resources and a keen understanding of the changes that will impact your reimbursement!nnThis year’s ICD-10 updates include 363 new codes, 142 deleted codes, and 250 code revisions.nnHere are notable highlights of the 2018 updates:n

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  • New musculoskeletal chapter codes to represent lumbar stenosis with or without neurogenic claudication
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  • New neoplasm chapter codes to identify all types of mast cell neoplasms, such as: malignant mast cell neoplasm, aggressive systemic mastocytosis, mast cell sarcoma, and other types.
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  • 72 new codes to identify non-pressure chronic ulcers that have penetrated muscle and bone tissue without necrosis
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  • New endocrine chapter codes to identify diabetes mellitus with ketoacidosis
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  • Myocardial Infarction codes now include specificity for type 1, type 2, and “other” MIs
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  • Two new subcategories have been created for heart failure to include specificity for right heart failure as well as chronicity, right heart failure due to left heart failure, biventricular heart failure, high output heart failure, and end-stage heart failure
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  • 17 new antenatal screening codes to identify specific screenings administered to pregnant patients, including testing for fetal growth retardation and chromosomal abnormalities
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  • New convention update regarding the use of the term “with.” The convention now specifies that, when another existing Guideline specifically requires a documented linkage between two conditions, the word “with” does not suffice. Providers will have to make it clear within their clinical documentation the cause-and-effect relationship between conditions that are related.
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  • Updates to the mental health chapter include explanatory information regarding substance abuse remission codes to include specificity for severity (i.e. mild, moderate, severe) in an effort to better align ICD-10-CM with the APA’s DSM-5
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n*Please note this list is not all-inclusive. Click here for a comprehensive list of all 2018 changes available at the CMS website.

Expect the Unexpected — While Maintaining Productivity! — Professional Development Tidbit

Welter Healthcare Partners is excited to present our helpful career advancing tips and strategies to sharpen the skills prospective employers look for in a coder!nnSoft Skills — Professional Development TidbitnnNo matter how much we plan things out and hope for the best, there will inevitably, always be something that we didn’t think of or plan for. That is why prioritizing, planning, and time management are such important skills to have in today’s job market. When you know what needs to be done and the deadline, you can be ready for anything that may come your way! Expect the Unexpected! You can’t see the future but if you are aware of your surroundings and potential obstacles, you can anticipate a need before it is asked of you. There is no room for procrastination in the ladder to success!

Top 5 Things to Know About New Effort to Replace ACA

Top 5 Things to Know About New Effort to Replace ACAGOP Senators are working quickly in an effort to garner votes to replace the ACA (Affordable Care Act). Check out the most important things to note about this replacement effort, below.nnRepublican efforts in Congress to “repeal and replace” the federal Affordable Care Act are back from the dead. Again.nnWhile the chances for this last-ditch measure appear iffy, many GOP senators are rallying around a proposal by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), along with Sens. Dean Heller (R-Nev.) and Ron Johnson (R-Wis.)nnThey are racing the clock to round up the needed 50 votes — and there are 52 Senate Republicans.nnAn earlier attempt to replace the ACA this summer fell just one vote short when Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska) and John McCain (R-Ariz.) voted against it. The latest push is setting off a massive guessing game on Capitol Hill about where the GOP can pick up the needed vote.n

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nThis article originally posted on Kaiser Health News.