Halloween Howlers

by Dianna Foley, RHIA, CHPS, CCS 


Test your ICD-10-CM coding skills with this Klutz family experience.

This Halloween each Klutz child went to a different party and of course, ended up with an injury.  See what transpires.

Raymond participated in a donut-eating race at the church party he attended and choked on the donut.  Quick thinking with some swift slaps on the back dislodged the offending food from his throat.  Little Dana went to a party at her friend Julia’s house where there was a mummy wrapping event.  Her partner wound so much toilet paper around her feet and ankles that little Dana tripped and fell on the sidewalk ending up with a big abrasion and bruise on her nose.  At the Boy Scout party Peter attended in the nearby forest, each child was carving a small pumpkin.  He slipped with the knife and had a superficial laceration on the palm of his left hand.  Egon went to the party at the high school where he dislocated the left side of his jaw while bobbing for apples.  It just so happened that one of the parents chaperoning the party was a dentist and knew just what to do to pop it back into place. Finally, Janine and a few girlfriends had a sleepover where they decorated each other with face paint in the bedroom of her best friend’s trailer.  Unfortunately, Janine developed an allergic urticaria to the paint and had to go home.  All-in-all minor mishaps for the Klutz children…at least this Halloween.

Click HERE for the answers.

Coding Hysterectomies

This installment of “Spotlight on CPT” presents information regarding the coding for hysterectomy procedures.  There are several different types of hysterectomy procedures: total/partial, abdominal/vaginal, and laparoscopic/open.  Some hysterectomy procedures include other procedures as well necessitating a combination code.  So let’s review.

A hysterectomy is the surgical removal of the uterus.  Most often, the procedure also includes the removal of the cervix.  When a total hysterectomy is performed, both the uterus and cervix are removed.  If only a partial hysterectomy is done, the cervix remains.  This is also called a supracervical hysterectomy.   

These procedures may be performed via a laparoscopic approach or through an open incision in the abdomen while others can be done vaginally.    

Once a coding professional determines the methodology of the procedure, then other details are needed to complete the coding.  For example, often the size of the uterus is a component of the code assignment.  CPT determines the cut-off point to be 250 grams.  Anything over that weight moves the code to another level.  Once the size has been determined and the appropriate category found, then a coder must look to see if any other procedures were done concomitantly.  Those other procedures could be removal of tubes and/or ovaries (which is the most common); the repair of enteroceles; partial vaginectomy; and lymph node procedures.   

Now, let’s look at some examples.  A patient has an open total abdominal hysterectomy for uterus 312 grams.  The code would be 58150.  If this was a laparoscopic procedure, the code changes to 58572, and if it was a vaginal procedure the code becomes 58290.  

There are times when a hysterectomy is performed vaginally but with laparoscopic assistance.  There is a specific section of codes (58550-58554) for those procedures.  

Just a quick mention about radical hysterectomy procedures.  These procedures are usually performed when there is a diagnosis of cancer.  This procedure will entail the removal of the uterus, cervix, bilateral fallopian tubes and ovaries, lymph nodes, part of the vagina, and possibly other surrounding tissue.  CPT has specific codes for radical hysterectomy procedures.

Now, light has been shed on coding for hysterectomies. 

About the Author 

Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.

OHIMA Receives the 2019 AHIMA Advocacy Triumph Award

At the AHIMA Convention in Chicago, AHIMA recognized the 2019 Triumph Awards recipients during the 80s themed Appreciation Celebration on September 17, 2019.  This honor is presented to members who have demonstrated excellence in their dedication and service to the health information management profession.  The ADVOCACY AWARD honors those who have exhibited long-standing and enthusiastic support of policy advocacy for the purpose of advancing the health information management (HIM) profession and practices.

AHIMA selected the Ohio Health Information Management Association (OHIMA) as the recipient of the 2019 AHIMA Advocacy Triumph Award.  While not a typical method of legislative advocacy for the profession, OHIMA’s application communicated a compelling case describing how OHIMA advocated for the HIM profession by creating a short, animated video that showcased the diverse job settings, skills, and functions that make up the HIM profession in an effort to help others to answer that question which is common to us all: “What exactly IS health information management?”  The purpose of the video creation by the OHIMA Board of Directors was to aid potential students, human resource departments, and the general HIM profession in understanding and communicating the HIM profession.

The video was revealed during the OHIMA 2019 Annual Meeting and Trade Show where members were encouraged to share the video broadly with employers, human resource departments, and HIM colleagues. Members and other CSAs helped to achieve almost 2000 views of the video within a few months of release. Kristin M. Nelson, MS, RHIA; Lauren W. Manson, RHIA; and the OHIMA Board are credited with leading this strategic advocacy project.  The video can be viewed on the OHIMA website under the “What Is HIM?” link.  AHIMA congratulated OHIMA as the recipient of the 2019 AHIMA Advocacy Triumph Award for successfully advocating for the profession, explaining exactly what HIM professional do, and encouraging others to join OHIMA to showcase the talent and importance of the HIM professional.

To view the video, visit the OHIMA website:
http://ohima.org/whatishim.html

 

If You Don’t Know, Now You Know… Membership Benefit 101: Education

In case you didn’t know, OHIMA implemented a new membership engagement strategy this year. What exactly IS membership engagement? It is "a collaborative investment between an organization and its members." The organization’s supporters contribute money, time, and passion, and the organization devotes energy to the member experience.  When I think about AHIMA and OHIMA, this definition holds true. Therefore, we wanted to showcase some of the benefits of being an AHIMA and OHIMA member. 

First up is access to education, which ends up more than covering the cost of the membership itself.

• Stay on top of news, developments, best practices, and updates in the field with the award-winning Journal of AHIMA - both digital and print. I don’t know about all of you, but I still enjoy getting the printed version in the mail. Having something right in front of me forces me to read and stay up-to-date on the profession and what other colleagues are doing.
  
  
• There are a variety of e-newsletters. One in particular is the AHIMA Smart Brief delivered daily showcases targeted news and information in sections that are leading in HIM. The first section is titled “Top Stories,” and then range from “technology and innovation” to “legislative and regulatory,” and ends with “news from AHIMA.” There is also a “featured content” section from SmartBrief.com that offers insights, analysis and best practices for the education professional.
    
  
• AHIMA’s HIM Body of Knowledge provides resources and tools to advance health information professional practice and standards for the delivery of quality healthcare. It enables HIM professionals to access quickly and easily information needed to be successful. Click on the large topic buttons and then further narrow your search by author, source, publication date or more specific topic. This is a vast improvement over pages of links that we have seen in the past.
  
  
• There are also a wealth of AHIMA discounted on-demand webinars in CDI, Coding, and Privacy and Security.  You can organize a group in order to make the cost minimal. In addition, OHIMA continually offers discounted webinars like tomorrow's Getting Clued In: 7th Character Coding for Injuries, Poisonings, and Fractures brought to you by Dianna Foley, OHIMA’s Coding Education Coordinator for only $25. This webinar counts for one AHIMA CEU and one AAPC CEU.

So if you didn’t know now you know…
 

About the Author 

Kristin Nelson, MS, RHIA is the currently President-Elect on the OHIMA FY 2020-21 Board of Directors, in charge of Membership Engagement strategy.  Kristin is a Clinical Instructor at The Ohio State University School of Health and Rehabilitation Sciences HIMS Division.