By Brenda Ray, CCS, CCS-P, COC, AHIMA-Approved Trainer ​

It is imperative that proper documentation and coding are utilized to document cardiac conditions accurately and streamline the cardiology billing process appropriately. In the following, our industry expert, Brenda Ray, delves deeper into some pertinent coding updates and guidelines around cardiac conditions. 
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Among the changes for 2023, new guidelines for Shunting Procedures have been added to clarify further the intent and correct reporting of existing codes 33741, 33745, and 33746.

With 25 codes going away and revisions to the introductory guidelines related to five different categories of codes, along with prolonged services revisions, the American Medical Association’s E/M changes, effective January 1, 2023, are significant!

​The sheer volume of changes may create uncertainty in revenue, affecting Revenue Cycle Management (RCM). When significant changes are tied directly to revenue, a focus on training and evaluation is necessary for organizations to remain on course to reach their 2023 RCM goals.

​No longer a regional illness concentrated in African countries, the monkeypox outbreak is growing as multiple countries continue to report new cases. According to the Centers for Disease Control and Prevention (CDC), there are 13,517 total confirmed monkeypox/orthopoxvirus cases in the United States alone as of August 17. 

​The new guidelines become effective October 1, 2022, which is right around the corner.  With multiple updates and clarifications to specific guidelines, the time is now for review and coder education! 

Professional and Employee Wellness Month is celebrated every year in the month of June, focusing on the importance of personal well-being and health in the workplace. Even more important, it brings light to the employer's role in promoting wellness and creating a healthy work environment.
 
At Axea Solutions, we believe our employees are unquestionably one of our most valuable assets. Our employees directly affect the quality of our work and the service provided to clients. People are one of the primary determinants of the success of any organization and often can be the most significant differentiator. This is why employee health and wellness is a core component of our corporate culture.  

Recognizing the hardworking revenue integrity professionals, during this Revenue Integrity Week ─ We applaud you all, and your dedication to address the complex challenges of your profession.

​Surprisingly, many still view revenue integrity as pertaining to just the billing and HIM department. Though important, these areas are simply pieces of the complex business of ensuring data accuracy and regulatory and contractual compliance with revenue integrity. 

The Centers for Medicare & Medicaid Services (CMS) released the 2022 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgery Center (ASC) Payment System final rule (OPPS Final Rule), finalizing several policies proposed, including provisions of the Hospital Price Transparency, substantially increasing financial penalties for non-compliance.

​A full year of non-compliance with the price transparency regulation can potentially result in a maximum penalty of about $2 million per hospital.

CMS is modifying the approach for presenting the new technology add-on payment (NTAP) related ICD-10-PCS procedure code requests that involve the administration of a therapeutic agent for the March 9-10, 2021 ICD-10 Coordination and Maintenance Committee meeting.

​CMS is soliciting public comments in advance of the meeting. Be sure not to miss your opportunity to participate. 

Since the beginning of the pandemic, there have been many code changes and updates related to COVID-19 (SARS-CoV-2), with even more for 2021, including new ICD-10-CM diagnosis codes implemented on January 1, 2021. Among these is code Z20.822, contact with and (suspected) exposure to COVID-19, which previously required the code Z20.828.  Pay attention to the specific dates around Z20.822 and Z20.828, as this will be critical for billing. 

There has been some confusion around updates related to the Glasgow Coma Scale (GCS) codes. Changes affecting GCS, though not clearly explicit but certainly significant, were made in the recent updates to the FY2021 ICD-10-CM Official Guidelines for Coding and Reporting.  

With multiple accounts of a lack of clarity around these changes, there have been discussions of additional specific guidance to be offered in the future, though no specifics given. ​Essentially, the revised guideline is designed to prohibit GCS reporting in non-trauma.