San Diego Health Information Association Newsletter Issue 72 March 2019

PRESIDENT’S MESSAGE

By Daniel Castanon, BS, RHIA I hope you have been enjoying the much needed rain in San Diego. Now we

can look forward to all the beautiful flowers this spring!

Did you know that March 24-30, 2019 is national HIP (Health Information

Professionals) week? Please take a minute to pat yourself on the back and

acknowledge all that you do. The work that health information

administrators do is vital to our communities. Take a moment sometime

this month to help educate a layperson about our field and how you

contribute to it. In other words, find an opening in a conversation and

explain to someone what you do. Here is a link to an AHIMA toolkit for

some ideas:

http://www.ahima.org/events?tabid=hipweek

Lastly, thank you everyone who took time to vote for next year’s SDHIA

board of directors. We invite you to our May 14th meeting at Tom Ham’s

Lighthouse where we will introduce the incoming 2019-2020 board

members!

INSIDE THIS ISSUE

UPCOMING EVENTS

PAST PRESIDENT’S MESSAGE

EDUCATIONAL CORNER

CODING CORNER

CALENDAR of EVENTS

Jobs.. Jobs.. Jobs..

UPCOMING EVENTS

March 12, 2019

Data Mapping and Interoperability and benefits of the HIE

LOCATION:

Sharp Techway

8520 Tech Way

San Diego, CA 92123

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San Diego Health Information Association Newsletter Issue 72 March 2019

UPCOMING EVENTS

Data Mapping and Interoperability

and The Benefits of HIE

Date: March 12, 2019

Time: 5:00 pm to 7:00 pm

Door Registration begins at 4:45 pm

Location: Sharp Techway Building

8520 Tech Way 1st Floor

Room 124 & 125A

San Diego, CA 92123

Speakers:

Maria Hewett, MBA, RHIA Vilena Boussarova, MS, RHIA, CHDA, CCS

Registration Fee: $17 CHIA Member $22 Non-CHIA Member $10 CHIA Member Student $15 Non-CHIA Student Continuing Education CEU’s: 2 AHIMA Domain: Performance Improvement, Technology

SDHIA does not endorse any company, vendor or product.

For more information, contact SDHIA President Daniel Castanon, RHIA at

SDHIA@CaliforniaHIA.org or call (619) 742-4519

For registration and payment online go to “Register”:

Although online registration is preferred, walk-in registration is available at the meeting site - Cash or Check Only. Please

make your check payable to SDHIA

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San Diego Health Information Association Newsletter Issue 72 March 2019

 

PAST-PRESIDENT’S MESSAGE

By Svetlana Woersching, RHIA, CCS, CPC CHIA/SDHIA Nominating Committee

The Nominating Committee is pleased to announce the results of 2019-2020 SDHIA and CHIA Ballots. These

HIM professionals have dedicated themselves to serve SDHIA and CHIA’s members in the upcoming Fiscal

Year and make the HIM profession stronger in the rapidly changing healthcare industry.

The new SDHIA’s 2019-2020 Board:

The new CHIA’s 2019-2020 Board

President-elect Hernan Amezcua, RHIA Secretary Ashley Baker, RHIT Treasurer Morgan Hezlep, JD, RHIT, CHC, CHPS CHIA Delegate Maria Hewett, MBA, RHIA CHIA Alternate Delegate Marci Arkin, RHIA

President-elect Melany Merryman, MSL, RHIA, CRCR (IAHIA) Directors Sally Gibbs, RHIA, CCS (SVHIA) Vivian Thomas, RHIA, CHDA, CHPS, CHPQ (GOCHIA) AHIMA Delegate Shirley Lewis, DPA, RHIA, CCS, CHC (SCHIA) AHIMA Alternate Delegate Liz Duggan Graham, RHIT, CCS (NCHIA)

Learn more about the CHIA Leadership Nomination Process and consider submitting your name next year for

the 2020 CHIA Ballot.

Again, please congratulate new 2019-2020 SDHIA and CHIA board members. Let’s celebrate at the May 2019

Spring Dinner Reception.

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San Diego Health Information Association Newsletter Issue 72 March 2019

 EDUCATIONAL CORNER By Keith Hass, RHIA

The SDHIA February 2019 monthly meeting was not held, but we did have a wonderful Coding Round Table

that took place.

Speakers: Judy Holloway, MPH, RHIA, CCS, CCS-P and John Folger, RHIA, CCS, CCS-P

TOPIC: Updated CPT Codes and ICD-10 CM/PCS Problematic Coding

Judy and John both gave a very interactive session during this Saturday morning event. The objectives of the

topic for the audience was met with interest and working discussions. The objectives were:

● Specific Case Examples

● Coding Clinic

● New Codes

● Guideline Changes

Specific examples and changes discussed:

CPT/HCPCS Update

Surgery

Radiology 2019 Medicare’s OP PPS

Facility E&M Guidelines

APC Packaging

OP Code Editor

NCCI Edits ICD-10-CM/PCS Coding

Problematic Issues

With those areas covered Judy and John brought the audience into deeper insight of BMI, Anemia, Surgery

General-Biopsy and Grafts, FNAB, PCNP, CNB as case scenarios examples. The event also made clarifications

on the 2019 Medicare’s OP PPS, The Outpatient Coder editor and national Correct Coding Policy manual 2019

Revisions.

Judy and John’s presentation discussion and active participation from audience revolved around how to

resolve issues through:

● Improving physician documentation and coding accuracy so it accurately describes the severity of

illness of patients that we treat.

● The goal to accurately portray the services we provide, not “game” the system.

● Whatever the ultimate reimbursement rate, accurately reflecting services provided and the reasons

for the services that we provide will result in appropriate reimbursement to our organization and

support the level of personnel allocated to the patient treatment process.

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San Diego Health Information Association Newsletter Issue 72 March 2019

 

THANK YOU

SDHIA’s February Coding Roundtable was a huge success! Not only did WIPFLi provide

knowledgeable and personable presenters, but also generously sponsored the event!

Thank You WIPFLi!!!!

CODING CORNER

PCS Coding: Knee Procedures By Nancy J Cervi, RHIT, CCDS

Highlights from the ICD-10 Coding Clinic, Fourth Quarter, 2018 This month’s article will review pertinent highlights from AHA’s Fourth Quarter, 2018, Coding Clinic. Be sure to review the complete coding clinic for other important topics.

TOPIC CODING CLINIC ADVICE

Endocrine/Body Mass Index Reporting: Provider documents obesity or morbid obesity in the

history and physical and/or discharge summary only,

without any additional documentation to support the

clinical significance of this condition, can it be coded?

Obesity and morbid obesity are always clinically

significant and reportable when documented by the

provider. In addition, if documented, the body mass

index (BMI) code may be coded in addition to the obesity

or morbid obesity code.

It would be appropriate to assign the BMI as a secondary

code with associated diagnoses such as malnutrition,

anorexia nervosa or other eating disorders, cachexia, and

abnormal weight loss/gain

NOTE: Do not assign codes for the body mass index

(BMI) during pregnancy. Assign only code O99.214, Obesity complicating childbirth, with the specific obesity

code from category E66-, Overweight and obesity, for

obesity complicating delivery.

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San Diego Health Information Association Newsletter Issue 72 March 2019

OB/Newborn:

Postpartum depression and Postpartum psychosis: Provider documents patient is seen 10 days after the birth

of her baby and is diagnosed with postpartum depression.

Assign code O99.345, Other mental disorders

complicating the puerperium, and code F53.0,

Postpartum depression, for postpartum depression. The

instructional note “use additional code to identify

specific condition,” at category O99, Other maternal

diseases classifiable elsewhere, indicates that a

secondary code is needed to specify the mental disorder.

NOTE: If patient is documented as with postpartum

psychosis, assign F53.1 Puerperal psychosis, for

postpartum psychosis.

GI/Hepatobiliary:

Gangrene and Perforation of Gallbladder in Cholecystitis:

Provider documents acute cholecystitis and cholelithiasis

with gangrene and perforation of the gallbladder.

Acute Appendicitis

Provider documents acute perforated appendicitis.

Assign code K80.00, Calculus of gallbladder with acute

cholecystitis without obstruction; code K82.A1, Gangrene of gallbladder in cholecystitis; and code

K82.A2, Perforation of gallbladder in cholecystitis.

Assign code K35.32, Acute appendicitis with perforation

and localized peritonitis, without abscess.

General Surgery:

Surgical Site Infection:

Provider documents patient underwent total abdominal

hysterectomy. On post-op day three, the incision was

intact but there was purulent drainage, slight erythema

and induration. Would was cultured and grew E. coli.

Control of Epistaxis:

Provider documents epistaxis with drop in hemoglobin.

Silver nitrate is applied to bleeding site via rigid nasal

endoscope.

Fine Needle Aspiration Root Operation when reporting

aspiration of tissue, such as lymph tissue

Assign code T81.41XA, Infection following a procedure,

superficial incisional surgical site, for the postoperative

wound infection. The infection involved only skin and

subcutaneous tissue of the surgical incision. Code

B96.20, Unspecified Escherichia coli [E. coli] as the cause

of disease classified elsewhere, is assigned as an

additional diagnosis.

Assign code R04.0, Epistaxis, for the epistaxis.

Assign code 093K8ZZ Control bleeding in nasal mucosa

and soft tissue, via natural or artificial opening

endoscopic for the application of the silver nitrate to

control the bleeding.

When reporting fine needle aspiration of tissue, such as

lymph tissue, report “Extraction” of the body part for the

tissue aspirated when available in the appropriate PCS

table. If “Extraction” is not available, then the root

operation “Excision” should be reported for fine needle

aspiration of tissue. FNA procedures of gas or fluid

should be reported to the root operation “Drainage”.

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San Diego Health Information Association Newsletter Issue 72 March 2019

Vascular:

Provider documents streptococcal Group B sepsis due to

a hemodialysis central venous catheter

Percutaneous Extracorporeal Membrane Oxygenation

Central:

Peripheral veno-arterial:

Peripheral veno-venous:

Denver Shunt (Placed percutaneously to recirculate ascitic

fluid)

Watchman Device Insertion and Removal

Assign code T80.211A, Bloodstream infection due to

central venous catheter, initial encounter, as the

principal. Assign code A40.1, Sepsis due to streptococcus,

group B, as an additional diagnosis, when a centrally

inserted hemodialysis catheter is the cause of sepsis. A

code from subcategory T80.21-, Infection due to central

venous catheter, specifies a central venous catheter,

distinguishing it from other dialysis catheters.

Assign code 5A1522F, Extracorporeal oxygenation,

membrane, central.

Assign code 5A1522G, Extracorporeal oxygenation,

membrane, peripheral veno-arterial.

Assign code 5A1522H, Extracorporeal oxygenation,

membrane, peripheral veno-venous.

NOTE: Central ECMO cannulation is an open-chest

procedure with direct surgical cannulation of the right

atrium and aorta. It involves two open insertions, arterial

and venous, and provides cardiorespiratory support. In

the past, central ECMO was more commonly used;

however, peripheral ECMO is more common now.

The objective of placing the Denver (peritoneovenous)

shunt is to remove and recirculate ascitic fluid from the

peritoneal cavity into the circulation and is classified to

operation “Bypass.” The root operation “Drainage” is not

appropriate because “Drainage” is meant to provide

intermittent relief of an abnormal collection of fluid.

Assign the following ICD-10-PCS codes:

0W1G3JW Bypass peritoneal cavity to upper vein with

synthetic substitute, percutaneous approach.

0JHT0YZ Insertion of other device into trunk

subcutaneous tissue and fascia, open approach, for the

placement of the pump valve. If the device is removed

prior to completion of the procedure (found to be

inadequate), code both the insertion 02H73DZ and

Removal 02PA3DZ. NOTE: Successful insertion of a Watchman device is

assigned 02L73DL Occlusion of left atrial appendage with

intralumuinal device, perc approach.

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San Diego Health Information Association Newsletter Issue 72 March 2019

Neurology:

Lacunar Infarction: Provider documents acute lacunar

infarct and encephalopathy secondary to the lacunar

infarction.

Joint Fusion Device Value Device value “Z No Device” has

been deleted from the tables:

0RG Fusion of Upper Joints

0SG Fusion of Lower Joints

Assign code I63.81 Other cerebral infarction due to

occlusion or stenosis of small artery. Also assign code

G93.49, Other encephalopathy, since the

encephalopathy is not inherent to the lacunar infarct.

If a fusion is performed and the device is not specified,

query the provider.

Diabetes with CKD and Hypertension As of October 1, 2018, the ICD-10-CM Official Guidelines

have been revised to read “Assign codes from category

I12, Hypertensive chronic kidney disease, when both

hypertension and a condition classifiable to category

N18, Chronic kidney disease (CKD), are present. CKD

should not be coded as hypertensive if the provider

indicates the CKD is not related to the hypertension.”

Radial Head Arthroplasty Body Part Value Radial head replacement surgery is now identified in the

following tables:

0PRH Replacement, radius, right

0PRJ Replacement, radius, left

Coding Clinic Conflicts with Official Coding Guidelines When there is a discrepancy between the conventions in

the classification, the guidelines and/or advice published

in Coding Clinic, coding professionals should adhere to

the following hierarchy:

1. Conventions in the ICD-10-CM and ICD-10-PCS classification 2. Official Guidelines for Coding and Reporting

3. Coding Clinic advice.

Excludes 1 Note Guidance: Peripheral vascular disease

and gangrene are documented.

Referencing the Tabular List, code I96, Gangrene, not

elsewhere classified, has an Excludes1 note below that

excludes “gangrene in other peripheral vascular diseases

(I73.-).” This note should be interpreted to mean “not

coded here” and that code I73.- should be assigned for

gangrene in other peripheral vascular disease.

References: AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, Fourth Quarter, 2018

San Diego Health Information Association, SDHIA

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San Diego Health Information Association Newsletter Issue 72 March 2019

 

CALENDAR of EVENTS

for 2018 - 2019

Date & Location Speaker Topic & Sponsor

September 25, 2018

(4th Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Lawrence Willis, EdD, RHIA

HIM Director at San Diego Vibra

Hospital, Faculty, Chicago State

University & Malcolm X College

Andrea Swenson

Motivational and Inspirational

Speaker.

Topic: What’s Next: Professional

Development and Career Mapping for

Today’s HIM Professional Leadership

Domain: Organizational Management

and Leadership

Sponsor:

September 29, 2018

(Saturday)

Location:

Sharp Corporate Bldg.

Sharp Auditorium

8695 Spectrum Center

Blvd

San Diego, CA 92123

Elvia Esquer, BS, RHIT, CCS

Adjunct Coding Professor at San

Diego Mesa College

Vilena Boussarova, MS, RHIA,

CCS

Hospital Impatient Regional

Coder at Kaiser Permanente,

Southern California

Topic: Coding Round Table

New ICD-10-CM/PCS 2019 codes

Domain: Clinical Classification

Systems and Coding

Sponsor:

October 23, 2018

(4th Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Health Law (Compliance)-Privacy

and Security

Kimberly Shutters, BS, RHIA

HIPPA Security Officer

Morgan Hezlep, Esq., J.D.

Topic: Health Law

Domain: Health Law and Compliance

Sponsor:

November 27, 2018

(4th Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Connie Renda, MA, RHIA,

CHDA

Program Director

Mesa College

Holly Jagielinski, RHIA, MPH

Professor

Mesa College

Topic: Leading the Way to Cultural

Competency in Healthcare

Domain: Organizational Management

and Leadership

Sponsor:

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San Diego Health Information Association Newsletter Issue 72 March 2019

Date & Location Speaker Topic & Sponsor

December 11, 2018

(2nd Tuesday)

Location:

Tom Ham’s Lighthouse

2150 Harbor Island

San Diego, CA 92101

Maria Alizondo , MOL, RHIT,

FHIMA

Director, HIMS at UCLA Health

System

Topic: Leadership through

Volunteerism

Holiday Party

Domain: Leadership

Sponsors:

January 8, 2019

(2nd Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Svetlana Woersching, RHIA, CCS,

CPC

Coding Quality Analyst, UHG,

Optum

Topic: Data Analytics Opportunities

in healthcare. Quality Improvement.

Domain: Performance Improvement

February 2, 2019

(Saturday)

Location:

Sharp Corporate Bldg.

Sharp Auditorium

8695 Spectrum Center

Blvd

San Diego, CA 92123

Coding Round Table

New 2019 CPT codes

Judy Halloway and an associate.

Cover CPT and some ICD-10 PCS

Topic: Coding Round Table

New 2019 CPT codes

Domain: Clinical Classification

Systems and Coding

February 12, 2019

(2nd Tuesday)

Location:

No Meeting this Month

No Regular Meeting this Month

Happy Valentine Day!

March 12, 2019

(2nd Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Maria Hewett, RHIA

Vilena Boussarova, MS, RHIA, CCS

Regional HIM Coder at Kaiser

Permanente, Southern California

Topic: Data mapping /data dictionary

and benefits of HIE

Domain: Performance Improvement

Sponsor:

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San Diego Health Information Association Newsletter Issue 72 March 2019

Date & Location Speaker Topic & Sponsor

April 9, 2019

(2nd Tuesday)

Location:

Sharp Techway Building

8520 Tech Way

1st Floor – Room A

San Diego, CA 92123

Noridian Topic: NCD/LCD Updates

May 14, 2019

(2nd Tuesday)

Location:

Tom Ham’s Lighthouse

2150 Harbor Island

San Diego, CA 92101

Connie Renda & SDHIA Board Topic: HOD Topics

Domain: Evolving Topics

Sponsor:

SDHIA Scholarships for CHIA Student Members

SDHIA has established a scholarship to support SDHIA CHIA

students who have completed 50% of their coursework

towards a credential in health information management.

SDHIA is committed to helping students complete their

education and enable them to successfully embark on their HIM career path. You must be a CHIA student

member if you have not signed up please register here: https://californiahia.org/join

SDHIA scholarship applications has been extended to March 15, 2019 deadline. The eligibility criteria,

application, and selection/notification process can be found here:

SDHIA: https://drive.google.com/file/d/1i6MT4ioVWk6D5_eoxYU0xe5HtAOeWb78/view?usp=sharing

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San Diego Health Information Association Newsletter Issue 72 March 2019

Treasurer Report

Checking: Savings:

Petty:Total:

March 2, 2019

$11,530.04$12,581.40

$67.00$24,178.44

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San Diego Health Information Association Newsletter Issue 72 March 2019

 

Jobs.. Jobs.. Jobs..

Sharp Healthcare: ► Claims Research Specialist ► Supervisor Compliance Auditor

Scripps Health: ► Patient Account Specialist ► Access Representative II - Utilization Review

Rady Children’s Hospital: ► Coder ► Coding Compliance Coordinator

Peak Health Solutions: ► Remote Inpatient Coder

Palomar Health: ► Coding & Documentation Integrity Manager ► Compliance Program Analyst UC San Diego: ► Various HIM Positions ► Manager, Training Team Medix: ► All San Diego Jobs Available

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San Diego Health Information Association Newsletter Issue 72 March 2019

CHIA BUSINESS SUBMISSION DEADLINES 1. July 31, 2018 CLA Name of the Nominating Committee Representative 2. July 31, 2018 CLA Financial Reports & Quicken data file 3. Jan 31, 2019 CLA Financial Reports & Quicken data file 4. Feb 28, 2019 CLA Leadership Rosters

● CLA Delegates to the 2019 CHIA House ● CLA Board Leaders for FY 2019-2020 (FY starts July 1, 2019)

5. May 1, 2019 CLA Proposed Budget 6. May 1, 2019 CLA Annual Report

SDHIA Social Media Corner

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Take advantage of the resources and the opportunity to network with your peers on AHIMA careers at:

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