Review HIV coding to ensure compliance
HIM Connection, August 2, 2011
Want to receive articles like this one in your inbox? Subscribe to HIM Connection!
Coding and sequencing HIV can be challenging for coders, so it's no surprise that CMS identified it as an area of compliance risk in the April Medicare Quarterly Compliance Newsletter. Following are some guidelines to help coders correctly sequence HIV codes.
- When a patient is admitted for an HIV-related condition, report ICD-9-CM code 042 (HIV) as the principal diagnosis, followed by additional diagnosis codes for all reported HIV-related conditions.
- When a patient is admitted for an AIDS-related condition, report ICD-9-CM code 042 as the principal diagnosis. AIDS-related conditions include those on the Major Diagnostic Category 25 list (HIV infections) or those that are tied to AIDS by a physician in his or her documentation.
- When a patient is admitted for an unrelated illness (e.g., a traumatic injury), report the unrelated illness (the nature of the injury) as the principal diagnosis, then report ICD-9-CM code 042, and any codes for HIV-related conditions as secondary diagnoses.
- When a patient has a known prior diagnosis of an HIV-related illness, report ICD-9-CM code 042 on every subsequent admission/encounter, but not necessarily as principal diagnosis.
Want to receive articles like this one in your inbox? Subscribe to HIM Connection!
Related Products
-
Prevent Denials and Win Appeals:
Hospital case managers and directors of case management will find Prevent Denials and Win Appeals to be a valuable partner...
-
The HIM Director's Guide to ICD-10
ICD-10 is the biggest change for the HIM industry since the implementation of DRGs in the 1980s. HIM directors must take...
-
2011 ICD-9-CM Manual Volumes 1 and 2
HCPro is pleased to introduce the 2011 ICD-9-CM Manual Volumes 1 & 2 for professional and non-acute care settings. Reserve...
-
Top ICD-9-CM Trouble Spots
During this 2-hour audio conference, our speakers address eight common, complex conditions and diagnoses and give you best...
-
Renal Failure Coding: Clinical indicators and documentation strategies
During this live 90-minute webcast, our expert speakers will provide the clinical background coders need to appropriately...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- HIPAA Q&A: Level of encryption needed for email
- QA:Coding multiple initial infusions
- News and briefs: Oklahoma Osteopathic Association against residency bill change
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- CMS has reformulated payments for some bilateral procedures
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- Hospitals are not bound by InterQual criteria for determining patient status
- ED-to-inpatient transfers are flawed with safety gaps
- Searched