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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- Left heart catheterization.
- Left ventricular angiography.
- Bilateral selective coronary artery angiography.
- Coronary artery bypass graft angiography x3.
- Coronary artery disease.
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nINDICATIONS:n
Prop for tricuspid valve surgery.
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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
With 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
2018 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
nnNo 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!
GOP 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
Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthcare will reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit, hospital care, nursing facility care, home service or domiciliary/rest home care reported in lieu of a consultation services procedure code. This notification will be the first of several communications to clarify this change in reimbursement strategy supporting our commitment to the Triple Aim of improving health care services, health outcomes and overall cost of care.nnUnitedHealthcare will align with the Centers for Medicare & Medicaid Services (CMS) and no longer reimburse consultation services represented by CPT codes 99241-99245 and 99251-99255. At the time of the original CMS decision to no longer recognize these consultation services procedure codes, UnitedHealthcare began pursuit of data analysis and trending to better understand the use of consultation services codes as reported in the treatment of our commercial members. Similar to CMS’s findings, our extensive data analysis has revealed misuse of consultation services codes for this population.nnThe current Relative Value Unit (RVU) assignments reflect numerous changes made during recent years to both E/M codes and other surgical services creating an overall budget neutral experience supporting this strategy as a more accurate reflection of services rendered.n