2011 OIG Workplan is Here.Dont Expect the Pain to Go AwayTALKING POINTSSome New, Some Not So New Codes Among 2011 CPTUsing Modiers to Report Reduced or Cancelled ProceduresThe Characters Behind ICD-10-PCSOCTOBER 2010FEATURE ARTICLE TALKING POINTS35
12The move to ICD-10-PCS from ICD-9 has been long awaited, reports Darnacea Harris, MHA, RHIT, CCS.The new coding classication is a multi-axial, seven-character alphanumeric code structure that provides unique codes for each procedure, she notes.The structure is based on individual letters and numbers, called values that occupy seven spaces of the code, called characters.
Procedure codes are seven characters long.Each represents an aspect of the procedure.A character can have one of 34 different values assigned.Gone are vague code descriptors that caused confusion and inconsistency in code assignment.
Instead, ICD-10-PCS offers a structure that is logical and consistent.2011 OIG Workplan is Here.Dont Expect the Pain to Go AwayThe Ofce of the Inspector General (OIG) has published the 2010 plan for Fiscal Year 2011.Why should you care? Because these are the issues that get passed to Medicare Administrative Contractors (MAC) and Recovery Auditor Contractors (RAC) and private payor auditors.
2011 Medicare Physician Fee Schedule Proposed Final Rule KeynotesThe proposed ruling contains policy proposals that will impact physician and non-physician practitioner (NPP) services paid under the MPFS, as well as other Medicare Part B payment policies that address Ambulance, Lab, End Stage Renal Disease services and Part B Drug coverage.Some New, Some Not So New Codes Among 2011 CPT UpdatesThe time has arrived for the 2011 CPT updates.Based upon MedAssets review and analysis of these codes, there only appears to be 343 CPT code changes for 2011.Using Modiers to Report Reduced or Cancelled ProceduresModiers 73 and 74 are used when reporting outpatient procedures that have been cancelled, interrupted, discontinued or terminated and anesthesia was either provided or it was intended to be used during the procedure.ALSO...FAQs, MedAssets Events and Presentations, Crossword PuzzleCCFN OCTOBER 2010MEDASSETS.COM3FEATURED ARTICLEDarnacea Harris MHA, RHIT, CCSThe move to ICD-10-PCS fromICD-9-CM has been long awaited and much anticipated.
The level of detail needed to classify diagnostic and procedural specicity far exceeds the language needed for ICD-9-CM code sets that have been in use in the United States since 1979.Codes listed in ICD-10 are geared toward improving quality of care data, more complete understanding of complications and to better track outcome of care.ICD-10-PCS adds more specicity to procedure classications and provides a better system for expansion
.The ICD-10-PCS coding classication is based on a multi-axial, seven character alphanumeric code structure that provides unique codes for each procedure.
Gone are the eponyms and vague code descriptors that caused confusion and inconsistency in code assignment.Instead, ICD-10-PCS offers a structure that is logical and consistent.The structure is based on individual letters and numbers, called values that occupy seven spaces of the code, called characters.All procedure codes in ICD-10-PCS are seven characters in length, and each character represents an aspect of the procedure.
The diagram below describes the seven characters that represent a complete code in the Medical and Surgical section of ICD-10-PCSEach character can have one of 34 different values assigned.These values can be numbers 0 through 9 and any of the alphabet (except I and O).The letters I and O are not used so as not to be confused with the numbers 1 and 0.The values for each character depend on the clinical procedure performed, and the section (or category in ICD-9-CM) where the procedure exists.In the ICD-10-PCS code 02103D4, for example, the 0 in character one has a different meaning than the 0 in character four.The differences are better illustrated in the diagram below.The following provides a general description of each character and its purpose.This is the rst character in an ICD-10-PCS code.This character identies the broad procedure category, or section, where the code is found.(In ICD-9-CM this would be the category).There are 16 sections of ICD-10-PCS.For example, the rst character in all Medical and Surgical codes is always 0; the rst character in all obstetric codes is always 1, and so on.Body systems specify the general clinical body system of the procedure.For example, the female reproductive system is represented by the value U, the endocrine system is represented by the value G, and procedures on the heart and great vessels are represented by the value 2. There are 30 values that represent body systems. SYSTEMROOT OPERATIONBODY OCTOBER 2010MEDASSETS.COM4FEATURED ARTICLEThe root operations identify the reason, or objective of the procedure.There are 31 precisely dened root operations that are grouped with procedures having similar attributes.Root operations represent a signicant change from ICD-9-CM procedure guidelines.ICD-10 coding guidelines for multiple procedures, for example, dene specic conditions for coding multiple procedures (ICD-10-PCS root operation guideline B3.3 multiple procedures).Examples of root operations include the 4 Body PartThis character denes the specic anatomic site where the procedure was performed.This is different from Character 2 where the general body system is identied.
There are 34 possible values for each body system.Within the body part H skin and subcutaneous tissue and breast, there are 17 body parts.
Examples include breast, right, abdominal wall, and subcutaneous tissue, thorax.
In ICD-10-PCS, the approach refers to the technique used to reach the si