Thursday, October 29, 2015

Updated "Ask a Coder" questions on HCC University!

We've added 9 new questions, most about ICD-10, to the Ask a Coder section on  In addition, most of the older questions have been updated to include ICD-10 information.

On the Full Encounter Data/ICD-10 page, we've added an updated CMS Encounter Data Processing System (EDPS) Newsletter, which reminds physicians and DME suppliers that ICD-9 and ICD-10 cannot be billed on the same claim/encounter.  If there are services both prior to and on or after 10-1-15, you must split them and put them on separate claims.

For hospitals, the discharge date determines which coding system applies to the whole claim.  So, if a patient is admitted on 9-20-15, and discharged on 10-1-15, all services will be billed under the ICD-10 coding system.

Finally, remember you can ask risk adjustment related coding questions by submitting an email to

Stay tuned for more exciting news from!

Updated Job Openings in HealthCare Informatics

We've recently had a position filled, so I wanted to be sure and post an updated list of jobs open in our HealthCare Informatics family.  If you're interested in one of the positions, click the link, and read the full job description.  You can apply online!  All of the positions are in our Long Beach office.

Job Title  Requisition Number  Position Type  Standard Hours 
Healthcare Informatics Analyst II 14-1588  Full Time - Regular  40 
Encounter Data Specialist - Report Analyst 15-1769  Full Time - Regular  40 
Project Manager - HCI 15-1863  Full Time - Regular  40 
Sr. Encounter Data Specialist - Technical Reporting Analyst 15-1904  Full Time - Regular  40 
Health Care Analyst Sr. 15-1919  Full Time - Regular  40 

Monday, October 26, 2015

Important Information on ICD-10 Excludes 1 Notes

Although the general ICD-10 instruction is that an Excludes 1 note means you cannot code two conditions together, the National Center for Health Statistics has posted an exception on their website. The NCHS is one of the 4 cooperating parties for ICD-10, and is responsible for posting the ICD-10 code book and guidelines.  The exception reads as follows:

"We have received several questions regarding the interpretation of Excludes1 notes in ICD-10-CM when the conditions are unrelated to one another. Answer: If the two conditions are not related to one another, it is permissible to report both codes despite the presence of an Excludes1 note. For example, the Excludes1 note at code range R40-R46, states that symptoms and signs constituting part of a pattern of mental disorder (F01-F99) cannot be assigned with the R40-R46 codes. However, if dizziness (R42) is not a component of the mental health condition (e.g., dizziness is unrelated to bipolar disorder), then separate codes may be assigned for both dizziness and bipolar disorder. In another example, code range I60-I69 (Cerebrovascular Diseases) has an Excludes1 note for traumatic intracranial hemorrhage (S06.-). Codes in I60-I69 should not be used for a diagnosis of traumatic intracranial hemorrhage. However, if the patient has both a current traumatic intracranial hemorrhage and sequela from a previous stroke, then it would be appropriate to assign both a code from S06- and I69-."

You can read the exception on their website, as well as download important ICD-10 documents at:

Thursday, October 15, 2015

Healthcare Informatics Job Postings

We just wanted to post all of our current Healthcare Informatic Job Postings for you.  You can click on the link to be taken to the job description, and information on how to apply for the job.  We hope you'll consider joining the Healthcare Informatics family!

Job Title  Requisition Number  City  Standard Hours  Post Date 
Healthcare Informatics Analyst II 14-1588  Long Beach  40  10/06/2014 
Data Analyst - HEDIS & Medicare Star 15-1694  Long Beach  40  02/06/2015 
Encounter Data Specialist - Report Analyst 15-1769  Long Beach  40  04/10/2015 
Project Manager - HCI 15-1863  Long Beach  40  07/02/2015 
Sr. Encounter Data Specialist - Technical Reporting Analyst 15-1904  Long Beach  40  08/20/2015 
Health Care Analyst Sr. 15-1919  Long Beach  40  08/27/2015 

Thursday, October 8, 2015

New Healthcare Informatics Job Posting

The position below was posted on October 5.  Please be sure to check out last Thursday's post for other positions still available as part of our Healthcare Informatics Family!  Just click on the job title to be taken to the full posting for the position.

Healthcare Informatics Analyst II 14-1588  Healthcare Informatics  Long Beach     

CMS ICD-10 Ombudsman and Coordination Center Available

I received the email below from CMS today, and thought I would share it with you.
CMS has established a coordination center and an ombudsman to help providers
 through this difficult transition to ICD-10. These are fantastic resources for providers,
so that they can resolve issues once they've exhausted their attempts to find the right
code for a situation.  It's reprinted below, and we hope you find it helpful.
Because of CMS formatting that I can't change, it does appear a little funny on our site, but the information is so useful, I hope you'll look past that.

News Updates | October 7, 2015

ICD-10 Ombudsman and ICD-10 Coordination Center
Here to Support Your Transition Needs

It’s important that you know help’s available if you have problems with ICD-10:
ICD-10 Ombudsman
Dr. Rogers, a practicing emergency room physician, is known to many of you 

 already. Since 2002, he has been the Director of the Agency’s Physicians
 Regulatory Issues Team, assisting physicians, other practitioners, and medical societies in identifying and simplifying Medicare policies and regulations. His role 
as ombudsman will be to be a one-stop shop for you with questions and concerns
 and to be your internal advocate inside CMS.
ICD-10 Coordination Center
The Coordination Center is a dedicated group of Medicare, Medicaid, and

   information technology systems experts drawn from across CMS. They have
 the full support of the entire CMS staff to address any issues quickly and 
First-Line ICD-10 Information and Support
  1. For general ICD-10 information, we have many resources on our                CMS ICD-10 website and Road to 10 webpage.
  2. Contact the MAC for Medicare claims questions. Your MAC                             is your first line for Medicare claims help. MACs cannot                                     respond to questions about Medicaid or Commercial health plans.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website and for the latest news and
 resources, including the ICD-10 Quick Start Guide. Sign up for
 CMS ICD-10 Email Updates and follow us on Twitter.

Tuesday, October 6, 2015

Using Diagnoses From Prior Encounters

One of the most common questions we get is whether or not a diagnosis from an earlier encounter can be used for a current encounter.

Standard coding advice has always been that a diagnosis cannot be "pulled forward" to a new encounter. Coding Clinic, Q3, 2013 has addressed this issue.  In part, the Coding Clinic advice says:

"Conditions documented on previous encounters may not be clinically relevant on the current encounter.... However, if the condition is not documented in the current health record, it would be inappropriate to go back to previous encounters to retrieve a diagnosis without physician confirmation."

Coding Clinic indicated this advice applies to both ICD-9 and ICD-10 coding.  We hope this advice will clear up this frequent question.

Thursday, October 1, 2015

ICD-10 Reminders!

The long awaited day is here--and ICD-10 is a reality.  Just a few reminders for claim/encounter submissions around the implementation date.

1)  Claims/encounters cannot contain both ICD-9 and ICD-10 codes.  If you have dates of service before 10-1 and on or after 10-1, the services should be split onto separate claims.
2)   If it is a hospital insurance claim/encounter, the "date of service" is the discharge date, and all services should be submitted with the coding system in effect on the discharge date.
3)  Still need help?  Check CMS' for more information.
4) Don't forget  We have several presentations on ICD-10 that should help!

Good luck, and happy coding!!

Job Openings in Healthcare Informatics

Below are the current job openings in our Healthcare Informatics Department.  As a reminder, all are full time postitions, in our Long Beach Office.  You can apply by clicking on the job title link.

Job Title  Requisition Number  Area of Interest  Position Type  Standard Hours 
Healthcare Informatics Analyst II 14-1588  Healthcare Informatics  Full Time - Regular  40 
Data Analyst - HEDIS & Medicare Star 15-1694  Healthcare Informatics  Full Time - Regular  40 
Encounter Data Specialist - Report Analyst 15-1769  Healthcare Informatics  Full Time - Regular  40 
Project Manager - HCI 15-1863  Healthcare Informatics  Full Time - Regular  40 
Sr. Encounter Data Specialist - Technical Reporting Analyst 15-1904  Healthcare Informatics  Full Time - Regular  40 
Health Care Analyst Sr. 15-1919  Healthcare Informatics  Full Time - Regular  40