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American Recovery and Reinvestment Act: Timelines to Know
Part Six in a Series
by Lou Ann Wiedemann, MS, RHIA, CPEHR

On February 17 President Barack Obama signed the American Recovery and Reinvestment Act (ARRA), one of the single largest health information technology laws in recent history. A total of $19.2 billion dollars will be dedicated to the implementation and support of health information technology over the next three-five years. This article will outline some of the important implementation dates for the healthcare industry. Read more.


Pressure Ulcer Stages
by Melanie Endicott, MBA/HCM, RHIA, CCS, CCS-P

A pressure ulcer is an area of skin that breaks down when an individual stays in one position for too long. This condition is most common in individuals who are in a wheelchair or bedridden. The ulcer occurs due to the constant pressure against the skin that reduces the blood supply to that area and the affected tissue dies.

In ICD-9-CM, pressure ulcers are classified according to site and stage. The most common sites of pressure ulcers are areas with bony prominences, such as the elbow (707.01), upper back (707.02), lower back (707.03), hip (707.04), buttock (707.05), ankle (707.06), and heel (707.07). The stages of pressure ulcers are as follows:

  • Stage I (707.21): A reddened area on the skin that, when touched, is “non-blanchable” (does not turn white).
  • Stage II (707.22): The skin blisters or forms an open sore. The area around the sore may be red or irritated. There is partial thickness skin loss involving the epidermis and/or dermis.
  • Stage III (707.23): The skin breakdown looks like a crater. There is full thickness skin loss involving damage or necrosis of subcutaneous tissue.
  • Stage IV (707.24): The depth of the ulcer is down to the muscle and bone, and sometimes tendons and joints.

When coding pressure ulcers, both the site (707.00-707.09) and the stage (707.20-707.25) must be coded, with the site sequenced first.

References
US National Library of Medicine: Medline Plus. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/007071.htm.  

Melanie Endicott (melanie.endicott@ahima.org), MBA/HCM, RHIA, CCS, CCS-P, is a practice resources specialist at AHIMA.


Neoplasm Review Crossword Puzzle

Click here to access the crossword puzzle and answer key.


ICD-10 Checkpoint

Check your knowledge. Compare ICD-9-CM codes to ICD-10-PCS codes.

What is the correct procedure code for Kyphosis and Lordosis?

Read more.


Coding Challenges for Discussion

Skin Ulcer Coding

Question: A physician documents “pre-ulcerative” skin lesion of the heel. The lesion is debrided. How is this diagnosis coded?

Question: What is the correct diagnosis code for decubitus ulcer of the coccyx? Should it be 707.03, Decubitus ulcer of the lower back, or 707.09, Decubitus ulcer, other site?

Question: A patient is admitted to the hospital with a stage II pressure ulcer of the heel. During the hospitalization, the pressure ulcer worsens and becomes a stage III. Based on the Official Coding Guidelines, we would be assigning the code for the highest stage for that site. What would be the correct POA indicator assignment for the stage III code?

Question: The physician debrided a coccyx wound with sharp excision down to the fascia and bone. How should the debridement down to the bone be coded? 


CodeWrite Continuing Education Quiz

To purchase this month’s CodeWrite quiz, log in to myAHIMA and select “CE Quizzes” followed by “Purchase Quizzes.” Choose CodeWrite Community News, November 2009 from the list of available items. Once you have completed your purchase you will be directed to the quiz page.

If you need more information about taking quizzes, please visit our quiz page.


AHIMA General Information

The coding roundtable process is designed to meet the needs of coding professionals by providing educational and networking opportunities. Our process is designed to be interactive—on the Internet and around the table where you work. AHIMA is the association of professionals engaged in or interested in the practice of health information management. The association, through its component state associations, provides support to members and strengthens the healthcare industry and profession by providing a voice that is 53,000-members strong. AHIMA members strive to ensure that healthcare is based on accurate and timely information.

Facilitation of accurate and consistent coding practice is a key element in carrying out this mission, so as an association we provide educational resources and representation in key national groups to support this goal. To ensure that its members meet professional standards of excellence, AHIMA issues professional credentials in health information management, including both entry-level and specialist certification related to coding. Active, associate, and student memberships are available. You can earn credentials through a combination of education, experience, and acceptable performance on national certification exams. Current AHIMA credentials include:

Registered Health Information Administrator (RHIA)
Registered Health Information Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist-Physician based (CCS-P)
Certified Coding Associate (CCA)
Certified in Healthcare Privacy and Security (CHPS)
Certified Health Data Analyst (CHDA)

Coding roundtable participation is not restricted to membership in AHIMA. The Internet-based Communities of Practice, containing a wealth of coding information and resources, is one of many membership benefits. For more information on AHIMA membership, visit www.ahima.org or call (312) 233-1100.

Participation in the coding community and the coding roundtables ensures an integrated network of coding professionals working together to raise the standard of excellence in the coding profession. By joining together, coding roundtables can solve common problems and provide input to groups and agencies that make a difference in our workplace and the industry we serve.

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CodeWrite is published twelve times a year by the American Health Information Management Association (AHIMA), 233 N. Michigan Ave., 21st Floor, Chicago, IL 60601-5809.

AHIMA respects its members' and nonmembers' Internet privacy and right to choose which communications they want to receive. You are currently subscribed to ahima_list5_codewrite as %%EMAILAddr_%%. If you prefer not to receive AHIMA CodeWrite click unsubscribe and you will be removed.

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November 2009

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Calendar of Events

November 10Physician Practice E/M Guidelines audio seminar

November 12ICD-10 Implementation for Hospitals virtual meeting

November 16-18AHIMA Academy for ICD-10
Baltimore, MD

November 19Coding Clinic Update audio seminar

December 32010 Procedure and Service Code Updates audio seminar

December 82010 Procedure and Service Code Updates audio seminar

December 10CY10 CMS OPPS Update audio seminar

December 15Advanced Coding Scenarios: An Expert Review audio seminar

December 17ICD-10 Implementation for Hospitals virtual meeting

For more information and full agendas visit www.ahima.org/meetings/.

Upcoming AHIMA Convention & Exhibit Dates and Locations

September 25–30, 2010
Orlando, FL

October 1–6, 2011
Salt Lake City, UT


Navigate the Transition to ICD-10

Use AHIMA’s ICD-10 Web pages as a resource to help guide you through the transition to ICD-10-CM and ICD-10-PCS.


Connect and Network with Your Peers

AHIMA offers many opportunities for you to network with others online, ask questions and learn from your peers, and hear about the latest news from AHIMA.

Communities of Practice

(Members only)
Answers, support, and career advice are available through this well-established professional network. AHIMA members enjoy a wide continuum of benefits:

  • Current coding news and practices
  • Online forums
  • Practical research materials
  • Relevant education resources

The Communities of Practice is a benefit of AHIMA membership. If you are already a member, go to http://cop.ahima.org. Your user name is your AHIMA member ID including the initial zero(s). For information on becoming a member, click here.

Become a Fan of AHIMA

Check out AHIMA’s Official Facebook page. There is also an AHIMA Careers page dedicated to students and recent graduates pursuing a career in the health information field. Become a fan of one (or both) of these pages and join in the discussions.

Follow AHIMA Resources on Twitter

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