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Healthcare Coding & Documentation 2012 Update

For the twelfth consecutive year, EisnerAmper's Healthcare Services Group is honored to have created and have the opportunity to present its 2012 Healthcare Regulatory Update.  

As healthcare consultants in the northeast market (NY/NJ/PA) with a combined 20 years of experience, EisnerAmper's Healthcare Services Group consistently monitors and educates itself on all regulations and updates from the Centers for Medicare and Medicaid Services (CMS) as well as the latest in healthcare reform from Washington. This preparation allows the group to discuss, educate and provide an audience comprised of healthcare providers, office staff and outside healthcare professionals with the latest information on the issues impacting the healthcare industry.

The 2012 Healthcare Regulatory Update includes the latest information on: Healthcare Reform, including the most recent changes to be implemented as part of the Patient Protection and Affordable Care Act; An Ambulatory Services update that includes physician reimbursement, EHR, Audit Insurance, revalidation, RAC’s;

A Hospital Services update that includes inpatient rates, outpatient rates, ACO’s, merger/acquisitions, new payment models, physician and nurse shortages; A Compliance update that includes HIPAA, Stark, Anti-Kickback statute, RAC’s and ZPICS.

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Coding Changes Reminder

  • Remember to change the following to reflect the new diagnosis and procedure codes for 2012:
    • Superbill / Encounter Form
    • Practice Management Software
     
  • Update ICD-9-CM and CPT Books

2012 Diagnosis Code Changes

Effective 10/1/11

168 New Diagnosis Codes 41 Revised Diagnosis Codes 33 Deleted Diagnosis Codes

  • Infectious & Parasitic Diseases
    • E. coli
      • Deleted (041.4) – E. coli – 1 code
      • New (041.41 – 041.49) – 4 codes
       
     
  • Neoplasms
    • Deleted – (173.0 – 173.9) – 10 codes
      • "Other malignant neoplasm of"
       
    • New – (173.01 – 173. 99) – 40 Codes
      • "Unspecified malignant neoplasm of"
      • "Basal cell carcinoma of"
      • "Squamous cell carcinoma of"
      • "Other specified malignant neoplasm of"
       
     
  • Blood and Blood-Forming Organs
    • Deleted – 2 Codes
      • 284.1 Pancytopenia
      • 286.5 Hemorrhagic disorder due to intrinsic circulating anticoagulants
       
    • New – 12 Codes
      • 282.40 – 282.47 - Thalassemia
      • 284.11 – 284.19 – Pancytopenia
      • 286.52 – 286.59
        • Acquired hemophilia
        • Hemorrhagic disorder
        • Hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies or inhibitors
         
       
     
  • Mental Disorders
    • Deleted – 310.8 – 1 Code
      • Other specified non-psychotic mental disorders following organic brain damage
       
    • New – 4 Codes
      • 294.20 – 294.21 – Dementia
      • 310.81 – Pseudobulbar affect
       
    • 310.89 - Other specified non-psychotic mental disorders following organic brain damage
     
  • Nervous System & Sense Organs
    • New - 13 New Codes
      • 365.70 – 365.74 – Glaucoma
        • Mild
        • Moderate
        • Severe
        • Indeterminate
         
       
     
  • Circulatory System
    • Deleted – 2 Codes
      • 425.1 Hypertrophic obstructive cardiomyopathy
      • 444.0 Embolism and thrombosis of abdominal aorta
       
    • New – 6 Codes
      • 425.11 Hypertrophic obstructive cardiomyopathy
      • 440.09 Other arterial embolism and thrombosis of abdominal aorta
      • Respiratory System
       
    • Deleted – 3 codes
    • New – 28 codes
      • Influenza A Virus
      • Pneumothorax
      • Pneumonitis
      • Pneumonia
       
     
  • Digestive System
    • New – 5 Codes
      • 539.01- 539.80
        • Infection & Complications
          • Gastric Band Procedure
          • Other Bariatric Procedure
           
         
       
     
  • Genitourinary System
    • Deleted – 1 Code
      • 596.8 Other specified disorders of bladder
       
    • New – 6 Codes
      • 596.81 – 596.89
        • Infection of cystostomy
        • Mechanical complication of cystostomy
        • Other complication of cystostomy
        • Other specified disorders of bladder
         
       
     
  • Pregnancy & Childbirth
    • Deleted – 1 Code
    • New – 4 Codes
      • Onset of labor after 37 weeks gestation but before 39 weeks by planned C-Section
        • With/Without Complications
         
       
     
  • Musculoskeletal System
    • Deleted – 1 Code
    • New Code – 1 Code
      • 726.13 Partial tear of rotator cuff
       
     
  • Congenital Anomalies
    • Deleted – 1 Code
    • New – 3 Codes
      • Pulmonary artery anomalies
       
     
  • Symptoms, Signs and Ill-Defined Conditions
    • Deleted – 2 Codes
    • New Codes – 4 Codes
      • Solitary pulmonary nodule
      • Nonspecific abnormal finding of lung field
      • Nonspecific reaction to tuberculin skin test
       
     
  • Injury and Poisoning
    • Deleted – 4 Codes
    • New – 19 Codes
      • Postoperative shock
        • Unspecified
        • Cardiogenic
        • Septic
        • Other
         
      • Anaphylactic reaction
        • Due to administration of blood and blood products
        • Due to vaccination
        • Due to other serum
        • Due to peanuts (revision)
         
       
     
  • Factors Influencing Health Status (V Codes)
    • Deleted – 4 Codes
    • New – 17 Codes
      • Personal History of:
        • Gestational diabetes
        • Pulmonary embolism
        • Anaphylaxis
         
      • Family History of:
        • Glaucoma
         
      • Acquired Absence of:
      • Hip joint
      • Knee joint
      • Other joint
       
     

 

 

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Contact Information 

Steven Bisciello, MBA EisnerAmper, LLP Manager, Healthcare Services Group 

EisnerAmper LLP is an independent member firm of PKF International Limited

The material contained in this presentation is for general information and should not be acted upon without prior professional consultation. 

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