Cchis newsletter february 2014


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CCHIS Newsletter for February 2014. Addresses the topics of Coding the Administration of Pharmaceuticals in ICD-9 & ICD-10 PCS and developing a ICD-10 Training Plan.

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Cchis newsletter february 2014

  1. 1. This topic specifically covers the pharmaceuticals in Section 00.1 in the ICD-9 coding book. A pharmaceutical substance can be defined as a chemical substance put together as a single active ingredient or it can be a combination of other pharmacological active substances. Pharmaceuticals are classified in various other groups besides their origin on the basis of pharmacological properties like manner of action and their pharmacological activity, such as route of administration, biological system affected, or therapeutic effects. The codes found in the ICD-9 PCS section for Pharmaceuticals include codes 00.10-00.19. The pharmaceuticals are administered mostly through injections or infusions with the exception of 00.10 Implantation of Chemotherapeutic Agent and 00.12 Administration of Inhaled Nitric Oxide. In comparison, ICD-10 PCS codes for this section are found in the Administration section. The Administration section includes infusions, injections, and transfusions, as well as other procedures. Both ICD-9 PCS and ICD-10 PCS list or describe procedures where a diagnostic or therapeutic substance is given to the patient The Pharmaceutical section of ICD-9 PCS is considered less traveled because it is less familiar than the therapeutic and prophylactic substances found in the 99.1-99.4 sections. Coders should become familiar with the “less traveled” pharmaceutical codes and their use so that they can make it a practice to capture them in their day to day coding activity. Coders, however, must be able to identify the pharmaceuticals and their components in order to code them accurately in ICD-10 PCS. A good Drug dictionary is an excellent reference tool whether it is a hard copy or a part of the office software package. PHARMACEUTICAL CODING, THE ROAD LESS TRAVELED WHAT TO EXPECT 1 The Road Less Traveled 2 Coding Scenario 3 ICD-10 Crunch Time 4 Requests for Coding Topics “The Pharmaceutical section is considered less traveled because it is less familiar….” FEBRUARY 2014 Volume 1 Issue 2 By Cynthia Brown, MBA, RHIT, CCS CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984 [phone] CODING YESTERDAY’S NOMENCLATURE TODAY® Coding the Administration of Pharmaceuticals in ICD-9 PCS & ICD-10 PCS CODING NEWSLETTER FOR HEALTHCARE CODING PROFESSIONALS
  2. 2. Page 2 Coding Yesterday’s Nomenclature Today Let’s take a look at the ICD-9 PCS code 00.12 Administration of Inhaled Nitric Oxide and how it would translate to ICD-10 PCS. Since the recognition of nitric oxide (NO) as a key endothelial-derived vasodilator molecule in 1987, the field of NO research has expanded to encompass many areas of biomedical research. It is now well established that NO is an important signaling molecule throughout the body. The therapeutic potential of inhaled NO as a selective pulmonary vasodilator was suggested in a lamb model of pulmonary hypertension and in patients with pulmonary hypertension in 1991. Because NO is scavenged by hemoglobin (Hb) on diffusing into the blood and is thereby rapidly inactivated, the vasodilatory effect of inhaled NO is limited largely to the lung. This is in contrast to intravenously infused vasodilators that can cause systemic vasodilation and severe systemic arterial hypotension. A newborn is diagnosed with pulmonary HTN associated with premature closure of the ductus arteriosus, pneumonia, meconium aspiration, prematurity, and lung dysplasia. In many infants with pulmonary hypertension, right-to-left shunting of venous blood across the patent ductus arteriosus and foramen ovale produces severe systemic hypoxemia. In other patients, closure of these vascular conduits causes right-side heart failure and systemic hypotension. Extracorporeal membrane oxygenation (ECMO) therapy is lifesaving for some infants with pulmonary hypertension; however, it is costly, invasive, and associated with important morbidities. Therefore, it is elected to administer inhaled nitric oxide. In ICD-9, the coder can simply arrive at the correct code by going to Administration in the ICD-9 codebook and then locate inhaled nitric oxide, 00.12. In ICD-10, the coder should go to Administration in Table of Contents of the 2014 Tables & Index, then Physiological Systems & Anatomical Regions (3E), next Administration, Introduction (3E0). The table should be followed down to the Body System/Region, Respiratory Tract (F), select the applicable approach (which in this case is via natural or artificial opening)(7), select Gas (S), and lastly Nitric Oxide (D). Therefore, in ICD-9 PCS the code is 00.12 while in ICD-10 PCS the code is 3E0F7SD. NO signaling pathway in the lung. “The therapeutic potential of inhaled NO as a selective pulmonary vasodilator is evident in patients with pulmonary HTN.” Coding Scenario
  3. 3. Coding Yesterday’s Nomenclature Today With the implementation date for ICD-10 only seven months away, it is literally “crunch time” for some organizations. The final stages of testing, modification, and retesting should be coming to a close. The education of staff should already be well underway. The transition from ICD-9 to ICD-10 could prove to be one of the healthcare industries most widespread changeovers of its kind in decades. The transition will push the limits of an organization’s human, financial, and technical resources to the maximum. By now, the costs are making even large organizations shake their heads. Hopefully, cost estimations were close to predictions. The education of major contributors to the success of the transition should have been included in the cost analysis. The plan for educational training should extend beyond the coders in an organization. With most organizations believing that educating and training staff is the key component to the success of the transition a Training Plan is crucial. Hospitals and other healthcare providers should at this point be making employee training a priority. A competent educator, whether inside or outside of the organization, should be consulted to develop a Training Plan. The Training Plan should be customized to meet the needs of your particular organization. The Educator should approach training with the mindset that each organization is unique and therefore have unique training needs. A formal assessment of the knowledge of the staff should be conducted before developing a Training Plan. The results of the assessment will determine the next steps to take in developing a Training Plan. The Assessment and Training Plan should include coders, physicians, other clinical staff, documentation specialists, and any other key staff who will be affected by accurate code assignment. The sooner a Training Plan is developed the better. Early development will give an organization time to put into practice what has been taught and to make adjustments in learning curves. Remember accurate and complete coding is a must in today’s economically challenged healthcare environment. Coding Yesterday’s Nomenclature Today Coding Health Information Services ® AHIMA approved ICD-10 CM/PCS Trainer ICD-10 CRUNCH TIME Is Your Training Plan Adequate? “Accurate and complete coding is a must in today’s economically challenged healthcare environment.”
  4. 4. Page 4 Coding Yesterday’s Nomenclature Today CCHIS Professional Affiliates AHIMA GHIMA AHIMA approved ICD-10 CM/PCS Trainer EDWOSB/WOSB VOSB SCORE Atlanta CyntCoding Health Information Services P.O. BOX 3019 Decatur, GA 30031 Phone: 404-992-8984 E-Fax: 678-805-4919 E-mail: or Requests for Coding Topics E-mail your coding topics using the format below to: CCHIS NEWSLETTER TERMS AND CONDITIONS OF USE All content provided in this “CCHIS Newsletter” is for informational purposes only. The owner of this newsletter makes no representations as to the accuracy or completeness of any information in this newsletter or found by following any link in this newsletter. The owner of will not be liable for any errors or omissions in information nor for the availability of this information. The owner will not be liable for any losses, injuries, or damages from the display or use of this information. The terms and conditions are subject to change at any time with or without notice. CODING YESTERDAY’S NOMENCLATURE TODAY®