by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA When is cutting not Division? If a tendon is involved, most of the time the answer is Release. Questions about cutting tendons have come up a lot lately in my consulting practice, so it’s time to tackle tendon procedures. Tendons connect muscles to bones and allow movement of […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA First things first. A bifurcation is like a fork in the road. Webster says that a bifurcation is “the point or area at which something divides into two branches or parts or the point at which bifurcating occurs.” Here are two examples as shown in the drawings. Bifurcated […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA Coding the root operation of Detachment when the surgeon doesn’t document the ICD-10-PCS terminology of high, mid, or low amputations can be a challenge. Physicians don’t need to document these words, but they do need to give the coder enough documentation to know where the amputation took place. […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA Fogarty catheters are different than other thrombectomy catheters, such as stent retrievers or aspiration catheters. Because of the differences, the approach which must be assigned to code accurately in ICD-10-PCS is also different. A Fogarty catheter enters the vessel through a cut-down because it contains a guidewire and […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA I never thought much about the “furthest anatomical site” until ICD-10-PCS Guideline B4.1c was added for 2018. This guideline says that when a procedure is performed on a continuous section of a tubular body part, we assign the body part that corresponds to the furthest anatomical site from […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA We recently heard from a reader: I ran into a case of Extraction vs Excision involving a percutaneous core needle lung biopsy. I was advised to use the root operation Extraction. However: If you go to the PCS index using the term ‘Core needle biopsy’ is says to […]

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA As many of you are aware, my PCS training sessions always begin with a refresher on the hierarchy of coding guidance (see box below). It was encouraging to see that Coding Clinic published a reaffirmation of the hierarchy of coding guidance in the 4th Quarter 2018 (p. 90) […]

Hear nationally recognized ICD-10 expert and Libman Education course author Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA, discuss ICD-10-PCS Updates for FY 2019: Guidelines in this free, brief presentation. Learn more from Lynn! Master the FY 2019 ICD-10 code changes in time for October with the ICD-10 Code Updates. Learn more here.

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA The controversy regarding Bronchoalveolar Lavage, or BAL, will finally be resolved in October. The BAL procedure is drainage of the cells of the alveoli using an endoscope and specific procedural steps, but the correct body part assignment has been challenging and troublesome. When coded correctly, the DRG seemed inappropriate. […]