FEATURE
2014 Coding Essentials
Join ASCA in Las Vegas this January for critical ASC coding updates, clarifications and advice and a special full-day ICD-10-CM session. BY CRISTINA BENTIN
Editor’s note: Get the coding informa- tion and tools you need to submit clean and accurate claims and improve your ASC’s collections in 2014 at ASCA’s 2014 Winter Coding Seminar, January 16–18, 2014, in Las Vegas. The program features top coding experts from across the country, valuable networking oppor- tunities and two-and-one-half days of multi-specialty content, including tips for navigating the International Clas- sification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), ap- plying new codes and clarifications, anat- omy and physiology essentials and advice for obtaining the documentation detail required to code procedures accurately. “Past coding seminar attendees spoke,
and ASCA listened,” says Cristina Bentin, president of Coding Compliance Man- agement in Baton Rouge, Louisiana, who helped develop the program. “Whether attendees are already ‘in the know’ or ‘need to know,’ ASCA’s 2014 Winter Cod- ing Seminar will not disappoint.” All presentations meet American Acad-
emy of Professional Coders (AAPC) and Certified
Administrator Surgery Center
(CASC) requirements. Here, Bentin provides more detail
about the program and the topics that in- dividual speakers will address. She also shares some of the reasons this informa- tion will be critical to ASC billing and coding operations in 2014.
Thursday
The general sessions on the first day of the program will include discussions regarding the American Medical Asso- ciation’s 2014 CPT changes
Caption to come. Lenia adi as eum explabore, aut. Pari aut quat estectur?
and the rationales surrounding these changes that are applicable to the ASC setting. These will include an analysis of reimbursement opportunities that will compare the perspective of the Cen- ters for Medicare & Medicaid Services (CMS) to that of commercial carriers. While not all changes, revisions or de- letions of procedures in 2014 fall within the CMS list of approved procedures and services, diligence in the understanding of these changes is essential for accurate reporting to those commercial carriers providing additional reimbursement. The speakers will explore the CMS edits clarification impacting orthope- dics. For example, in previous years, an excerpt from the National Correct Cod- ing Initiative (NCCI) edits stated, “the definition of different anatomic sites includes different organs or different lesions in the same organ. However, it does not include treatment of contigu- ous structures of the same organ. . . . ” This led to further questions regarding the definition of contiguous structures and adjoining areas. In 2013, CMS NCCI Policy Manual Chapter 4, CPT codes 20000–29999 Revision date 1/1/2013 guideline PG IV-15 provides an update. An excerpt of that update states: “. . . An NCCI procedure to procedure edit code pair consisting of two codes describing two shoulder joint procedures should never be bypassed with an NCCI-associated modifier when performed on the ipsi- lateral (same) shoulder joint. This type of edit may be bypassed only if the two procedures are performed on contralat- eral (different) joints.” What does this mean in laymen’s terms from both the CMS and commercial carrier perspec- tive going forward? The expert speakers will explain.
20 ASC FOCUS NOVEMBER/DECEMBER 2013
In addition to CPT Changes, an ICD-10-CM overview will be presented during Thursday’s general session as a precursor to Saturday’s full-day session on ICD-10-CM.
Whether attendees are already ‘in the know’
or ‘need to know,’ ASCA’s 2014 Winter Coding Seminar will not disappoint.”
—Cristina Bentin
Facilities must understand that all applications touched by ICD-9-CM will have to be modified to work with ICD- 10-CM. How will facility carriers be impacted? Consider potential modifica- tions in claims adjudication rules with certain services being covered and paid, while other previously covered services will be pended or denied. Loss or mis- interpretation of information from a clinical standpoint will invariably dis- tort the ability to ensure neutrality with respect to claims reimbursements. Dual systems will have to be available dur- ing transition and after October 1, 2014. ICD-10-CM is date of service driven, so services provided prior to October 1, 2014, will need to be billed with ICD- 9-CM codes. Physicians cannot be expected to document appropriately if they are not aware of the increased detail required in their clinical documentation. Clini- cal documentation from all clinical staff will need to withstand the higher level of specificity found in ICD-10-CM.
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