Medical Coding Tips Billing Hypertensive Heart Disease скачать в хорошем качестве

Medical Coding Tips Billing Hypertensive Heart Disease

Q: “I’m confused when I bill hypertension AND hypertensive heart disease. Do I use both codes I10 and I11.9?” When they say “bill” they were referring to the diagnosis coding. That’s what we will be focusing on today. A: First of all, we need to look at our coding guidelines because there is something on there regarding this topic. For this, it indicates that hypertensive with heart conditions that are classified to those that are mentioned in the guidelines, we are to assign I11.-whatever that other factor is. Also, to add the additional codes from category I50 which is the heart failure code sections. When it comes to this, the provider is directly linking hypertension and heart disease together. In ICD-9 we didn’t have that privilege to assume a correlation between a heart disease and hypertension since we were only able to do hypertension and CKD. Now, for this, there is a combination code for hypertensive heart disease and that is I11.9; therefore, we would not use I10 as it is a combination code so it is included in that I11.9 code. When it comes to education with providers, it’s important that they understand how far do they need to specify each clinical condition for coding purposes. For example, this one, there is a hypertensive heart disease with and without heart failure. So, there’s a lot of places where we can further specify these codes by directly linking these conditions together. So, we have hypertensive heart disease, we have hypertensive heart and chronic kidney disease. So, the more that the provider documents appropriately or accurately will better reflect the patient’s true health status. What we’re going to do next is to look at the coding path for hypertensive heart disease. These snippets come from Find-A-Code which most of you do have included in your course or your CCO Club membership or you need to purchase it separately. So, when you use the tool, the ICD-10-CM Index tool, you will see when you would look for heart with the intentional term for the disease, you will see hypertensive heart disease without heart failure. That’s what I was mentioning before that you would need to educate the provider whether that patient has heart failure and if so, which type of heart failure does that patient have. Is it diastolic, is it systolic, or is it a combination of diastolic and systolic heart failure? Now that we stated the correct code for hypertensive heart disease, next we’re going to be looking at how do we code for hypertensive heart disease with a specific heart failure, or just a generic heart failure. Now, once you code this combination code per the instructions of the coding guidelines, you need to add the additional code for the type of heart failure that the patient has. As you can see here, there is an additional step for the heart disease is it’s that one, I11.9 is without heart failure. But if you see the indentation of the relational term “with” and that’s something that you also need to refer to in your coding guidelines for that conventional terms and symbols because it’s important that you need to understand how important that one little relational term is in connecting conditions from the medical record according to the alphabetical index. When you get to the “with” part, you can further specify that this patient does have heart failure and it is documented and supported in the note, so you would use the I11.0. Like I said before if there is any other complications or conditions such as chronic kidney disease, then that’s something that needs to be taken into account as well as there is a combination code for all three of those conditions. Now, I already said this already so we need to indicate for the heart failure is the diastolic, systolic or combination of the diastolic and systolic heart failure. That is the run-through of how you would appropriately code for hypertensive heart disease. There’s a lot of information so I cannot stress enough the importance of using the alphabetical index. We get so accustomed to using the Tabular especially for conditions that we have memorized. But lo and behold there are times where each year the coding pathway maybe different than the previous year, and so it is crucial that you make sure that you go back to the alphabetical index because that will not lead you astray, where some of these encoders can lead you if you’re not aware or know what pathway you need to take in order to get to that correct code. So, this is why I use encoders but I still love my manual. There’s nothing that can ever replace that and even if you want to get certifications this is great but you can’t use an encoder on exams, so it’s still important that you understand and know how to maneuver around your manuals as they change. There is so much information on there and it’s just a great thing that we have.