Diseases and procedures are hitting the news.
Last week, the Food and Drug Administration (FDA) announced that 35 people had reported seizures (R56.9) after using electronic cigarettes (F17.290). The seizures were considered adverse events and involved children and young adults. Seizures are possible side effects of nicotine poisoning (T65.221-). The agency is requesting consumers to report any issues with e-cigarettes. Seizures have been reported by people who vaped for the first time and regular users.
In reviewing the coding, it was interesting that there is no adverse reaction code for nicotine. The code above is for accidental poisoning.
The United States declared the elimination of measles in 2000, but almost 400 cases have been reported from Jan. 1-March 28, across 15 states. There are currently six outbreaks happening in the United States, which include Rockland County, N.Y.; New York City, Washington state, Santa Cruz County, Calif.,; the state of New Jersey, and Butte County, Calif.. These outbreaks have been attributed to travelers bringing the disease from foreign countries. The people who contracted measles were unvaccinated.
A story from Sacramento, Calif. was published regarding 200 people who were exposed to measles, as a child in the emergency room of a local hospital was diagnosed with the disease. The patient was initially thought to have the flu, but was later diagnosed with measles. The ICD-10-CM code for encounter for vaccination is Z23.
The Centers for Disease Control and Prevention (CDC) has announced the makeup of the 2019-2020 flu tri-valent vaccine, which will cover:
The quad-valent will add coverage for B/Phuket/3073/2013-like (Yamagata lineage).
The CDC had a delay in selecting the H3N3 vaccine component. It is not known if the delay will impact the timing or availability.
When coding this condition, it is important to remember that associated manifestations such as pneumonia, other respiratory conditions, and gastrointestinal issues will change the code.
For the past five years, public health researchers have been trying to identify the responsible virus that causes acute flaccid myelitis (AFM). The researchers need to understand the triggers and how it works in order to develop a vaccine. Currently, it is believed that non-polio enteroviruses (EV-D68) are the culprits. It is particularly troubling that this virus occurs every other year – 2014, 2016, 2018 – and the rate of occurrence is rising. The researchers are now looking at spinal fluid for the virus antibodies rather than the virus. They are also reviewing AFM patients’ genetic histories to understand why some children are susceptible. The goal is to be prepared to diagnose and treat the disease in case it returns in 2020.
There was not a proposed code for AFM in March, but perhaps in September, a proposed code will be submitted.
Mick Jagger underwent transcatheter aortic valve replacement, TAVR, on April 4. The femoral artery was used to access his aortic valve. His tour will now begin in July rather than this month, as initially planned. Due to the minimally invasive procedure, he’ll be dancing in the streets after a short recovery time.
The ICD-10-PCS code is dependent on the type of material used to replace the valve. PCS includes autologous material, zooplastic, synthetic material, and nonautologous material.
Correction: This article has been corrected: the code for vaping should be F17.290 rather than F17.219
Programming Note:
Listen to Laurie Johnson report this story live today during Talk Ten Tuesday, 10-10:30 a.m.
Resources:
https://www.cdc.gov/flu/about/season/flu-season-2019-2020.htm
https://www.popsci.com/virus-acute-flaccid-myelitis-paralysis
This week I thought I would revisit the concept of what provider documentation is. It is becoming increasingly difficult for clinical documentation integrity (CDI) and
UnitedHealthcare (UHC) Medicare Advantage will begin reinforcing denialsbased on its interpretation of the International Classification of Disease, 10 thEdition, Clinical Modification (ICD-10-CM) Excludes 1.(https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-reimbursement/rpub/UHC-MEDADV-RPUB-JAN-2026.pdf) As
Please log in to your account to comment on this article.
Expert presenters Kathy Pride, RHIT, CPC, CCS-P, CPMA, and Brandi Russell, RHIA, CCS, COC, CPMA, break down complex fracture care coding rules, walk through correct modifier application (-25, -57, 54, 55), and clarify sequencing for initial and subsequent encounters. Attendees will gain the practical knowledge needed to submit clean claims, ensure compliance, and stay one step ahead of payer audits in 2026.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
