ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment

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ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment

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ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment

 


Have you started your ICD-10 training? If you haven’t, the time to start is right now! Nationally recognized coding expert, Joan L. Usher, BS, RHIA, COS-C, ACE, will help you begin training with her new, comprehensive ICD-10 coding training manual. Specific to home health, this manual gives detailed coding training and how-to guidance for the top diagnoses in the homecare setting and breaks down some of the biggest changes that are featured in ICD-10.

When ICD-10 goes into effect, home health agencies must include ICD-10 coding on their claims to prove medical necessity of their services per Medicare coverage guidelines. ICD-10 coding is complex and even the most seasoned ICD-9 coder will need education and training to code correctly under this new system due to the significant increase in codes and specificity required with coding.

ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment will provide coding tutorials, as well as, analysis and guidance on the most common diagnoses and most challenging coding situations within the homecare setting. The book also features an exam to test your knowledge and ensure coder proficiency.

ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment is a companion resource to Beacon Health’s ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation. Together, these resources will help your agency remain profitable and compliant under the ICD-10 coding system.

This book provides:

  • Coding how-to for the most common diagnoses in the homecare setting
  • An overview of OASIS-C1 and how it will accommodate ICD-10 codes
  • Guidance on how to properly document and code in ICD-10 to ensure proper Medicare payment


Table of Contents


PART I: Understanding the Fundamentals of ICD-10-CM Coding

  • Introduction
  • The change from ICD-9 to ICD-10
  • Getting to know the ICD-10 Manual
  • Understanding the Coding Manual – format and setup
  • Conventions and terms
  • Four easy steps to follow to code accurately


PART II: Home Health Specifics – What You Need to Know

  • Primary and other diagnosis
  • Effective management of the coding process
  • Coverage criteria
  • OASIS
  • Receiving appropriate reimbursement
  • Case-mix and coding
  • Taking therapy coding to a new level
  • Ethical coding practice


Part III: Coding for Diagnostic Areas

  • Certain Infectious and Parasitic Diseases (codes A00-B99)
  • Neoplasms (codes C00-D49)
  • Diseases of the Blood and Blood-Forming Organs & Certain Disorders Involving the Immune Mechanism (codes D50-D89)
  • Endocrine, Nutritional and Metabolic Diseases (codes E00-E89)
  • Mental & Behavioral Disorders (codes F01-F99)
  • Diseases of Eye & Adnexa (H00-H59) and Diseases of Ear & Mastoid Process (H60-H95)
  • Diseases of the Nervous System and Sense Organs (codes G00-G99)
  • Diseases of the Circulatory System (codes I00-I99)
  • Diseases of the Respiratory System (codes J00-J99)
  • Diseases of the Digestive System (codes K00-K95)
  • Diseases of the Skin and Subcutaneous Tissue (codes L00-L99)
  • Diseases of the Musculoskeletal System and Connective Tissue (codes M00-M99)
  • Diseases of the Genitourinary System (codes N00-N99)
  • Pregnancy, Childbirth, and the Puerperium (codes O00-O9A)
  • Certain Conditions Originating in the Perinatal Period (codes P00-P96)
  • Congenital Malformations, Deformations and Chromosomal Abnormalities (codes Q00-Q99)
  • Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (codes R00-R99)
  • Injury, Poisoning, and Certain Other Consequences of External Causes (codes S00-T88)
  • External Causes of Morbidity (V01-Y99)
  • Factors Influencing Health Status and Contact With Health Services (Z00-Z99)


Final Exam


About the Author

Joan L. Usher, BS, RHIA, COS-C, ACE, is president of JLU Health Record Systems in Pembroke, Mass. Usher has more than 25 years’ experience as a consultant and is a nationally recognized expert in the field of ICD-9-CM coding and health information management (HIM). She has taught ICD-9 coding in home health for 13 years and has educated more than 7,500 people nationwide. Usher is a past president of the Massachusetts Health Information Management Association. Under her leadership, Massachusetts received four national awards from AHIMA in continuing education programs, support for accredited HIM education, legislative advocacy, and electronic communications. She has contributed to numerous national publications and is the author of HCPro’s ICD-9 Coding for Home Health: A Guide to Medical Necessity and Payment. Usher is currently pursuing ICD-10 trainer certification from AHIMA.


Product Number: ICD10CHH_0582

Reviewed for accuracy: 2013-11-1

ISBN: 978-1-61569-279-8