OHIMA FY21-22 Board President Message

Hello OHIMA Nation! I am excited to get the 2021-2022 Ohio Health Information Management Association year off and running! I am honored to serve as the OHIMA President.  This will be a year of comebacks and new horizons.  As many of you may still be at home or are working a hybrid schedule or maybe have come back to the office full time, there is always work to be done. As HIM professionals our roles may have changed, our setting may have changed but what doesn’t change is the tenacity, adaptability and drive to make sure information gets to those that need it. 
 
The board is hard at work this summer, we met in June to discuss project plans for the next year, collaboration of resources and our plans for OHIMA’s future. Also, in June there was the Membership business meeting where our bylaws were voted on and approved to align with that of AHIMA and the new membership models.  We heard from Katherine Lusk, current AHIMA President with an emphasis on community and our role as an association. Lead, Serve, Represent embodies AHIMA and its members as the leading voices of authority in health information, that Health information is Human information and as an organization we are committed to the excellence in the management of health information for the benefit of patients and providers.
 
As the year continues to take shape so will our OHIMA events and meetings. Both the Fall Coding Symposium and annual meeting are gearing up to offer a hybrid meeting format; allowing for those that are ready to get out and meet up again the opportunity to do so but also for those that prefer a virtual offering will be able to benefit from all that OHIMA will have to offer. 

Stay tuned for updates and meeting information, continue to include the OHIMA webpage as part of your frequent internet hits, check out the OHIMA Facebook, Twitter and Instagram pages as well as the OHIMA blog to keep up-to-date on all things OHIMA and health information.  If you want to be heard feel free to contribute to the blog, we would love to hear from you. 

I am excited to get this year going and to be a part of such an amazing organization of HIM professionals.  Feel free to reach out to me or our OHIMA support staff with any questions you may have. 
 
Have a great year!

Amanda Wickard, MBA, RHIA, CPHI
OHIMA Board President FY 2021-2022
wickarda@woodcountyhospital.org

 

The Role of the Privacy Office

Listen to a podcast, "The Role of the Privacy Office" on YouTube. Featuring:

 

Jill Z. Choi, MBA, RHIA, CHPC
Director, Health Information Management, CDI, & UR
Nationwide Children's Hospital, Columbus, OH

Tiffany Perrine, CHPC
Associate Privacy Officer
Nationwide Children's Hospital

Veronica Pabon
Privacy Associate
Nationwide Children's Hospital, Columbus, OH

Tricia Householder
Privacy Associate
Nationwide Children's Hospital, Columbus, OH

 

Thanks to OHIMA Board Director, Alonzo Blackwell, and his team of Project Leaders who put this together!

Cardiovascular Monitoring Services

 “Spotlight on CPT” this month takes a look at cardiovascular monitoring services.  With constant improvements in technology, it is no wonder that cardiovascular monitoring services are continuing to evolve. 

Holter monitors, as pictured on the left below, were one of the first methods of continuous recording of electrocardiographic (ECG) data.  These devices can include up to 48 hours of continuous recording.  The codes are in the 93224-93227 range.  93224 is the comprehensive code which includes the recording, scanning analysis with report, review and interpretation by the physician or other qualified healthcare professional.  Each of the remaining codes breaks out each piece of the comprehensive code, so only the specific component performed is billed, when the comprehensive service is not done.  This includes 93225 for the recording only (which does include the connection and disconnection); 93226 for the scanning analysis and report, and then 93227 for the physician review and interpretation. 

With new devices now capable of longer-term recording and pictured on the right below, the CPT updates for 2021 have included two new sets of codes to capture those monitoring services.  Code range 93241-93244 is for recordings that are greater than 48 hours and up to 7 days.  The second code range spans 93245-93248 and is for external ECG recording for more than 7 days up to 15 days.  Both of these sets of codes are set up in the same manner as the initial Holter monitor codes, with one comprehensive code covering the entirety of the service, and then additional codes which break the service down into its components if an entity or provider only provides a specific component of the service. 

The big take-away here is that while the same information is being collected in each service, the difference is over what time period the data collection is taking place.  Coding professionals must be attentive to that distinction in order to ensure the correct code assignment is made.

Source: https://seekingalpha.com/article/4248365-irhythm-technologies-inc-growth-reversal-will-leave-investors-heartbroken

Now, light has been shed on cardiovascular monitoring services.

 

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.

COVID-19 Principal Diagnosis Assignment

Coding professionals are aware that the selection of the principal diagnosis is key when coding inpatient accounts.  In this edition of “In the kNOW”, we’ll take a look at how this applies when coding for COVID-19. 

The most straightforward concept is when a patient is admitted and treated specifically for COVID-19.  In these circumstances, it is clear that the U07.1 code for COVID-19 would be sequenced as the principal diagnosis. But happens when there is a wrinkle to the situation, for example, a pregnant patient has COVID-19?  Let’s break that down and see how it should be coded.

First, if the pregnant patient is admitted for care related to COVID-19, then the Official Coding Guidelines instruct us to assign O98.5- (Other viral diseases complicating pregnancy, childbirth, and the puerperium) as the principal diagnosis.  This would be followed with the U07.1 code for the COVID infection.  Code assignment follows this standard because sequencing priority is always given to Chapter 15 (Pregnancy, Childbirth, and the Puerperium) codes. 

Next, if the admission is for delivery – let’s say for a breech presentation that requires a C-section and the patient has COVID – then the code assignment here should reflect the breech presentation (O32.1-) as the principal diagnosis, followed by the codes O98.5-, and U07.1 to identify the COVID infection.    

That brings us to coding for the newborn.  When coding for a newborn birth record, the principal diagnosis code will always be from category Z38 (Liveborn infants according to place of birth and type of delivery).  If the newborn is determined to have COVID-19, and documentation states it was contracted in utero or during the birth process, then P35.8 (Other congenital viral diseases) is also assigned followed by a secondary code of U07.1.  If the mode of transmission is not identified, then simply assign U07.1.

Another circumstance where U07.1 is not assigned as the principal diagnosis is when coding for a lung transplant complicated with a COVID infection.  Under Official Coding Guideline I.C.19.g.3.a (Transplant complications other than kidney), instructions are provided to sequence T86- (Complications of transplanted organs and tissues) first with a secondary code assigned to capture the complication, which in our case would be U07.1 for the COVID-19 infection.      

An additional instance that can impact the assignment of a COVID-19 diagnosis is when it is present with sepsis.  In that scenario, coding professionals are directed to follow the sepsis coding guidelines at I.C.1.d.

Finally, remember outside of the circumstances noted above, coding professionals must still apply the principal diagnosis definition when determining the principal diagnosis on each and every account.  If the COVID-19 infection meets that definition, then assign U07.1 as the principal diagnosis, but if not, it should be assigned as a secondary.

Now you are In the kNOW!!

 

 

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.