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Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules and how they impact hospital health information management systems and processes, coding, billing, and reimbursement.

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Briefings on APCs

Issue 12, December 1, 2012 - VIEW THE FULL ISSUE

• Reduce compliance risk by correctly appending ­modifier -25 for E/M visits

  Misusing modifier -25 (significant, separately ­identifiable E/M service by the same physician...

• Consider dual coding to prepare for ICD-10 transition

  One of the interesting-and frequently mentioned-topics at the AHIMA National Convention...

• Walk through observation case studies

  Coding for observation services can be confusing and complicated. Review these three case studies...

• CMS issues supervision requirement decisions based on Hospital ­Outpatient Payment Panel recommenations

  The Hospital Outpatient Payment Panel recommended CMS change the supervision requirements for 15...

• This month's coding Q&A

  Our coding experts answer your questions about observation orders, sequencing additional diagnoses...

Issue 11, November 1, 2012 - VIEW THE FULL ISSUE

• Unravel complexities of ­billing self-administered drugs

  Because of the increase in the number and type of outpatient services provided, more patients are...

• October I/OCE, OPPS updates include minor changes

  CMS made two manual corrections as part of the OPPS update for October 2012 and included a number...

• It's time to reboot your ICD-10 transition plans

  Now that HHS has finalized a new ICD-10 implementation date, it’s time to kick start your...

• This Month's Coding Q&A

  Our coding experts answer your questions about how to determine the correct units for...

Issue 10, October 1, 2012 - VIEW THE FULL ISSUE

• Ensure accurate reporting and coding of critical care

  When the AMA revised the instructions for reporting ancillary services with critical care in 2011...

• ICD-10 anatomy refresher: Shoulder

  As part of our ongoing series of articles help coders prepare for the transition to ICD-10-CM, we...

• Simplify chronic kidney disease outpatient coding

  Recognize the stages of chronic kidney disease to unravel coding confusion.

• This Month's Coding Q&A

  Our coding experts answer your questions about coding for hysteroscopy prior to ablation, appending...

Issue 9, September 1, 2012 - VIEW THE FULL ISSUE

• CMS plans major changes to payment calculations

  CMS is proposing two major changes as part of the 2013 OPPS proposed rule, released July 6. One has...

• Supervision delay extension for CAHs among proposals

  CMS proposes extending non-enforcement of supervision requirements, asks for comments on...

• Compare coding for diabetes in ICD-9-CM, ICD-10-CM

  Many coders can quickly quote the code for diabetes mellitus in ICD-9-CM (code 250.00) when the...

• This Month's Coding Q&A

  Our coding experts answer questions about reporting dialysis for ESRD patient in ED, coding for...

Issue 8, August 1, 2012 - VIEW THE FULL ISSUE

• Simplify the decision to use modifier -59

  A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator...

• Differentiate between types of coding edits

  Coders can run into two types of edits that may ­require them to append modifier -59 (distinct...

• Factor in appropriate resources for ED E/M criteria

  Coding for physician services doesn’t always match coding for facility services, which can...

• Device-to-procedure edit reinstated, new codes added

  HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable...

• This Month's Coding Q&A

  In this month's issue, our coding experts answer questions about how to differentiate between...

Issue 7, July 1, 2012 - VIEW THE FULL ISSUE

• Simplify ­diagnostic, ­procedural pain ­management coding

  Pain is an expected component of injuries, illnesses, and surgical procedures. Let's face it...

• Differentiate between types of wound debridement

  A physician can debride a wound to remove dead, damaged, or infected tissue so the remaining...

• Coders need to learn to read an operative report

  To correctly assign codes for any surgical procedure, coders need to have an operative (OP) report...

• This Month's Coding Q&A

  Our coding experts answer your questions about correct use of modifier –PD, coding infusions...

Issue 6, June 1, 2012 - VIEW THE FULL ISSUE

• Injections and infusions continue to confuse coders

  Consider this scenario: A physician orders three hours of hydration as well as a one-hour...

• ICD-10 anatomy refresher: Get to know the skull

  With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in...

• Note changes for skin substitutes, mental health codes

  Facilities can't bill for skin substitutes unless they also bill for a skin substitute application...

• HHS proposes one-year delay for ICD-10 implementation

  Providers and payers may have an additional year to transition to ICD-10-CM/PCS if the Department...

• This Month's Coding Q&A

  Our coding experts answer your questions about payment for items in OPPS Addendum B and skin...

Issue 5, May 1, 2012 - VIEW THE FULL ISSUE

• Catch up on what's new with injections and infusions

  Poor documentation and a lack of clear guidance continue to cause coders to struggle with reporting...

• Fracture coding in ICD-10-CM requires greater specificity

  Coders will need more information in order to code for fractures in ICD-10-CM. For instance, the...

• Compare ICD-9-CM, ICD-10-CM coding for spinal conditions

  Spinal conditions can be congenital, pathologic, or traumatic, and they can affect the vertebrae...

• This Month's Coding Q&A

   Our coding experts answer your questions about  unsuccessful foreign body removal...

Issue 4, April 1, 2012 - VIEW THE FULL ISSUE

• Determine when to charge inpatient supplies separately

  Coders and billers may not completely understand how to charge for inpatient supplies. One...

• This Month's Coding Q&A

  Our coding experts answer your questions about  molecular pathology codes, HCPCS codes for...

• Take a trip through the digestive system

  Editor’s note: To help coders prepare for the upcoming transition to ICD-10-CM, we will...

• ICD-10-CM coding: Start with the structure

  The transition to ICD-10-CM is coming. The only question is when. Despite the delay, coders and...

Issue 3, March 1, 2012 - VIEW THE FULL ISSUE

• Correctly bill ancillary ­bedside procedures in ­addition to the room rate

  As technology evolves, providers can perform more procedures at the patient's bedside than they...

• ICD-10 anatomy refresher: Respiratory system

  The respiratory system, responsible for ­inspiration (carrying oxygen into the body) and...

• CMS adds new modifier -PD, two edits, additional APCs

  Modifier -PD (diagnostic or related nondiagnostic item or service provided in a wholly owned or...

• This Month's Cding Q&A

  Q Addendum B of the APC updates for 2012 indicates the new molecular pathology codes have status...

Issue 2, February 1, 2012 - VIEW THE FULL ISSUE

• Code and guideline changes spread throughout surgery ­subsections

  In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual, 18...

• Note major updates to pathology and laboratory section

  Coders can find the largest number of new codes in the pathology and laboratory section of the 2012...

• Defining 'integral' tricky for self-administered drugs

  Self-administered drugs present a significant issue for coders, especially when considering how...

• This Month's Coding Q&A

  Q We're struggling with nursing documentation of stop times for IV infusions (e.g., piggybacks and...

Issue 1, January 1, 2012 - VIEW THE FULL ISSUE

• CMS finalizes numerous provider-friendly OPPS changes for CY 2012

  Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac...

• Reevaluate charge setting in light of 2012 OPPS final rule

  Hospitals received a timely reminder about the importance of properly setting charges in CMS' 2012...

• This Month's Coding Q&A

  Our coding experts answer your questions about determining ED visit level, coding open reduction...

• Briefings on APCs 2011 index

  Track down that hard-to-find Briefings on APCs article. Use our index to find articles we published...