The deadly coronavirus has been the impetus for these new codes.
ICD-10-CM has significantly changed in that we are now getting updates, albeit limited ones, twice a year. The bulk of changes and additions are made on Oct. 1, but on April 1 of next year, we are getting a few as well. COVID-19 has been the impetus for this evolution of adaptation, and the upcoming codes relate to the virus: (https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software).
There is not a good way to monitor breakthrough infections currently, unless one were to read the medical record in its entirety. We were instructed (and I concurred) to not use Z28.3, Underimmunization status in the context of COVID-19. If the vaccines are being administered under an emergency use authorization (EUA) and there is no general mandate, then how can you conclude that someone is underimmunized? The intent of that code was to identify infants and children who have not undergone the recommended vaccination regimen.
It is no April Fool’s joke that on April 1, 2022, this code set is expanding. The upcoming codes are:
“Unvaccinated” is obvious. Defining “partially vaccinated” is going to be problematic. A person is considered fully immunized two weeks following the second dose of Pfizer or Moderna, or two weeks after a single-dose vaccine, e.g., Janssen/Johnson & Johnson (J&J). But we have determined that immunity wanes.
As of Friday, Nov. 19, the Centers for Disease Control and Prevention (CDC) expanded eligibility for booster shots to all adults. They are recommending booster shots for all J&J recipients at least two months post-initial dose, essentially rendering it a two-dose series. For Pfizer and Moderna, the recommendation is that a third full-dose shot be given to patients who are immunocompromised. For others, a booster shot is now suggested. Moderna’s booster shot is a half-dose, whereas Pfizer’s is administered in the same dosage as the first two shots. The CDC is also now allowing for mixing and matching manufacturers.
Some states had already taken the extraordinary step of expanding eligibility for COVID-19 boosters for everyone 18 and older, exceeding the recommendations of the Food and Drug Administration (FDA) or CDC; Arkansas, California, Colorado, New Mexico, and West Virginia had done so.
What is ultimately going to constitute “fully vaccinated?” Two weeks after a second dose of Pfizer or Moderna, and within six months after completing the primary series, a person is fully vaccinated. But after the six months have elapsed, am I now considered only partially vaccinated? What happens if we discover we need a yearly booster shot? Those vaccination cards are really not going to fit into our wallets!
It seems to offend some folks’ sensibilities that a code was created for this single virus vaccination. COVID-19 has infected over 250 million people worldwide and caused over 5 million deaths, with more than 750,000 deaths in the United States alone. It is the only airborne pandemic of this magnitude that we have lived through. Coronaviruses do not mutate at the speed with which influenza morphs. It is very important to capture data on who is coming down with breakthrough infections.
We are so fortunate that scientists were able to develop such safe and efficacious Coronavirus vaccines in such an expeditious fashion. Overall, there are 14 immunizations or series recommended for all adults over the age of 18: (https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html).
My sister was a guinea pig for the chicken pox vaccine, and I don’t remember any societal resistance in 1995, when varicella vaccine was added as a mandatory vaccine by each state and Washington, D.C. for children in school or daycare, unless they had permanent natural immunity from having had the disease. No one pitched a hissy fit when a safe rotavirus vaccine was added to the childhood vaccination schedule in 2006 (https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html), either. The CDC has not been able to add COVID-19 to its list yet because of the political climate, and who knows if it ever will.
We are going to have to see what the official guidance is regarding the concept of partial vaccination. All I know is that Z28.311 is a code that will never grace my medical record. If they told me I need a booster every six months, I’d do it. I consider myself lucky to have side effects heralding the development of antibodies and protection.
Please have a safe and happy Thanksgiving! It is still not advisable to have huge gatherings, especially if people are unvaccinated. The prevalence is trending up again, especially in cold climates. If you can request that your guests be vaccinated and eat outside, open some windows, or use an air filter, you will be safer. If everyone gets vaccinated, maybe next year the holidays can go back to the old normal.
Programming Note: Listen to Dr. Erica Remer live today when she co-hosts Talk Ten Tuesdays with Chuck Buck at 10 Eastern.
Today I am going to focus on a new ICD-10-CM code, as of Oct. 1: Z51.A, Encounter for sepsis aftercare. We think about sepsis mortality
Average annual growth in national health spending over the next decade is projected to be 5.6 percent, outpacing projected overall GDP. The developed nation that
Please log in to your account to comment on this article.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
This webcast, presented by Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, a recognized expert with over 30 years of experience, offers essential strategies to improve outpatient clinical documentation integrity. You will learn how to enhance the accuracy and completeness of patient records by adopting best practices in coding and incorporating Social Determinants of Health (SDOH). The session also highlights the role of technology, such as EHRs and CDI software, in improving documentation quality. By attending, you will gain practical insights into ensuring precise and compliant documentation, supporting patient care, and optimizing reimbursement. This webcast is crucial for those looking to address documentation gaps and elevate their coding practices.
ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
This webcast, presented by Tiffany Ferguson, LMSW, CMAC, ACM, addresses the critical gap in Social Determinants of Health (SDoH) reporting for pediatric populations. While SDoH efforts often focus on adults, this session emphasizes the unique needs of children. Attendees will gain insights into the current state of SDoH, new pediatric Z-codes, and the importance of interdisciplinary collaboration. By understanding and applying pediatric-specific SDoH factors, healthcare professionals can improve data capture, compliance, and care outcomes. This webcast is essential for those looking to enhance their approach to pediatric SDoH reporting and coding.
Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, VP of CDM, for a webcast addressing oncology service coding challenges. Learn to navigate coding for infusions and injections alongside Evaluation and Management (E/M) services, ensuring compliance and accurate reimbursement. Gain insights into documenting E/M services for oncology patients and determining medical necessity. This webcast is essential to optimize coding practices, maintain compliance, and maximize revenue in oncology care.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
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!
