Code Encounters

Reasons why most skilled nursing settings need coding assistance are abundantly clear. Even the most experienced MDS Coordinator or a staff member who has become coding certified in the last year may not understand the minutiae of the code and the magnitude of coding to reimbursement and survey outcomes. Here’s a short list of potential errors to consider:

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Whether you are a MDS Coordinator intensifying your knowledge of ICD-10s or a Coder training in skilled nursing services, SNFs and PPS swing bed programs are tasked with “perfection” on October 1. The Patient-Driven Payment Model (PDPM) demands discipline specific coding that captures the need to be inpatient and the care being provided each resident.

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The “code first” note is your hint that two codes may be needed, along with sequencing direction. The “code first” note is an instructional note.

If you see “in diseases classified elsewhere” terminology you will assign two codes, with the manifestation code being sequenced after the underlying condition. The “in diseases classified elsewhere” (manifestation) code is actually part of the code title. The code with “in diseases classified elsewhere” documented can never be used as a principal diagnosis.

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There can be confusion on how to report lateral- LT/RT and bilateral modifiers-50.

Coders report many of these incorrect or miss reporting altogether.

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There is a false impression that medical coders sit in their pajamas all day while entering codes consisting of letters and numbers.

Here is what a coder’s job truly consists of!

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What is the difference? We'll tell you! 

When looking for a job in the medical coding world, there is often some confusion between facility coding and professional coding.  The main difference is that professional coding is mandated by CMS and facility coding is facility based.  In this article, we are going to focus on the difference in the emergency room setting.

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