Code Spotlight — M48.062 Spinal Stenosis Lumbar Region with Neurogenic Claudication
Welter Healthcare Partners is excited to present our monthly Code Spotlight! Each month, Welter Healthcare Partners will spotlight a unique CPT or ICD-10 code to profile and discuss practice applications of the code, as well as pertinent guideline reminders.nnM48.062 – Spinal Stenosis, lumbar region, with neurogenic claudicationnThe list of ICD-10 code updates is extensive and lumbar spinal stenosis got a makeover with this year’s revision. The previous code M48.06 – Spinal stenosis, lumbar region will no longer be valid as of October 1st. There are now two new code options to replace the old code. These options now include specificity for neurogenic claudication. Spine surgeons and coders will be excited to finally have a code to capture this level of specificity!nnIt is important for coders to understand the clinical definition of neurogenic claudication. “Neurogenic claudication is the medical term used to describe the symptom of pain induced by walking,” according to spinal-healthcare.com, which goes on to call the condition “a hallmark symptom of lumbar stenosis.” Clinical documentation should include indications of trouble walking in the operative notes. If there is no indication of ambulatory issues or other signs of neurogenic claudication, you’ll assign the code for lumbar stenosis without neurogenic claudication; if the note describes the patient as having ambulatory issues due to stenosis, this could indicate claudication, in which case you’ll need to assign M48.062.
As part of the new coding format for our newsletter, Welter Healthcare Partners is excited to offer you a new surgery coding series in which we want to help you! The 2nd week of every month we will highlight a complicated surgical case. This week we are highlighting a general surgery case. We want to hear from you! If you have a complicated surgery case and need help with coding, 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. 
As a result of the many provisions of the Affordable Care Act (ACA), the CMS Innovation Center (CMMI) was created to promote quality healthcare, stronger health outcomes, and encourage fiscal responsibility. CMMI acts as the facilitator for designing the most efficient payment methodology for reimbursing healthcare providers based on value rather than volume. CMMI also provides a platform for doctors, stakeholders, and other health care partners to participate in a collaborative process for generating the ultimate pay-for-performance model.nnCMMI is responsible for the implementation and oversight of Quality Payment Program (QPP), which aligns all other incentive programs such as Meaningful Use, Value Based Payment Modifier, and PQRS. Practices will begin to see the financial impact of QPP starting in 2018. Upcoming CMMI initiatives include:n
Biomechanical Device Coding: Spine surgery has been one of the specialties hardest hit by recent CPT code bundling, NCCI edit updates, code revisions and additions, and RVU decreases. Most recently, biomechanical device coding changes were implemented, which impacts many spine surgery practice’s bottom lines. This change essentially states that all anterior instrumentation is now bundled with device anchoring. This will affect all operative anterior spinal procedures that involve instrumentation and caging. CMS has stated they will only allow use of modifiers to bypass these bundling edits if the surgeon performs additional anterior instrumentation unre¬lated to anchoring the device. However, clinical documentation must support the medical necessity and detail the procedure at great length. It is imperative that spine surgery practices understand the fundamentals of compliant coding and clinical documentation as it pertains to these changes.n
CMS released a proposed rule earlier this month that could cancel two bundled payment programs, and significantly limit a third.nnTwo bundled payment programs could be canceled before they begin, and the scope of a third will be significantly limited if a 
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!nnTeamwork – Ever heard of the expression – “Team Work Makes the Dream Work”? This idea serves as the foundation for many successful movements, companies and organizations. One person can only do so much and when we allow others to contribute their talents and ideas, extraordinary things can happen! There is no “I” in team and there are no lone rangers. Think about Julius Caesar, Napoleon, Gandhi, Steve Jobs, and many other life-changing leaders – they never could have influenced the world without millions of people working alongside them and supporting their efforts. Teams come in all shapes and sizes and it is important to be a team player. Group effort is always more effective than individual effort!