Coding, Classification & Reimbursement

Question about Coding Clinic

  • 1.  Question about Coding Clinic

    Posted 11-08-2018 13:20
    I hope this question makes sense, but do Coding Clinics "expire"? In other words, is there a point where they become irrelevant or outdated? For example, I am reading some coding guidance at my job that someone created, and the person who created the guidance referenced a Coding Clinic from 1992, which I feel like should not be used as a valid source since it is so old.  Any thoughts or opinions on this?

    Thank you!

    Ellen Johnston, RHIA, CRC

  • 2.  RE: Question about Coding Clinic

    Posted 11-09-2018 09:32
    Coding Clinics do not expire per se. However, guidance in Coding Clinic that is superseded by new official coding guidelines,Coding Clinic advice, new body part additions, or root operation definition changes, etc must be reviewed based on the newer information.and the older advice may be irrelevant. Even the ICD-9-CM Coding Clinics may still be relevant in the ICD-10-CM coding world as not all scenarios were updated for ICD-10-CM. Coders must evaluate older advice based on newer information to determine its relevance.
    Laura C Jones, RHIT, CCS
    ICD-10-CM/PCS Coding Validator

  • 3.  RE: Question about Coding Clinic

    Posted 11-09-2018 09:47
    ​This issue was addressed in 4Q 2015: The Central Office on ICD-10-CM and ICD-10-PCS has received numerous requests to advise users how past issues of AHA Coding Clinic for ICD-9-CM are to be utilized in the ICD-10 environment.

    In general, clinical information and information on documentation best practices published in Coding Clinic were not unique to ICD-9-CM, and remain applicable for ICD-10-CM with some caveats. For example, Coding Clinic may still be useful to understand clinical clues when applying the guideline regarding not coding separately signs or symptoms that are integral to a condition. Users may continue to use that information, as clues-not clinical criteria.

    As far as previously published advice on documentation is concerned, documentation issues would generally not be unique to ICD-9-CM, and so long as there is nothing new published in Coding Clinic for ICD-10-CM and ICD-10-PCS to replace it, the advice would stand.

    Previously published ICD-9-CM advice that is still relevant and applicable to ICD-10 will continue to be re-published in Coding Clinic for ICD-10- CM/PCS. As with the application of any of the coding advice published in Coding Clinic, the information needs to be reviewed carefully for similarities and differences on a case by case basis. Care must be exercised as the codes may have changed. Such change could be related to new codes, new combination codes, code revisions, a change in nonessential modifiers, or any other instructional note. This is particularly true as ICD-10-CM has many new combination codes that were not available in ICD-9-CM. For example, previous Coding Clinic for ICD-9-CM advice has indicated that hypoxia is not inherent in chronic obstructive pulmonary disease (COPD) and it could be separately coded. Coders should not assume this advice inevitably applies to ICD-10-CM. The correct approach when coding with ICD-10-CM is to review the Index entries for COPD, and determine whether or not there is a combination code for COPD with hypoxia, verify the code in the Tabular List, and review any instructional notes. The coder should then determine whether to code the hypoxia separately-and not automatically assume that a separate code should be assigned.

    In order to simplify the learning process, when the Cooperating Parties developed the ICD-10-CM guidelines, every attempt was made to remain as consistent with the ICD-9-CM guidelines as possible, unless there was a change inherent to the ICD-10-CM classification. If a particular guideline has remained exactly the same in both coding systems, and Coding Clinic for ICD-9-CM has published an example of the application of that guideline, it's more than likely that the interpretation would be similar.

    Susan Roehl