Category Archives: ICD 9

MedPro Healthcare Solutions: About Us

MedPro Healthcare Solutions provides affordable, flexible remote solutions to your home health coding needs. We provide ICD-9-CM Coding, Coding Audits, and Coding Education.

Between RACs, ZPICs, reimbursement cuts, and more, it has never been more important for agencies to have error free coding to avoid incorrect reimbursement, case-mix, and, most importantly, noncompliance.

With so many details to keep up with and compliance at stake, coding has become more challenging and time-consuming for clinicians to complete. So, let us help you stay up to date and error free. MedPro Healthcare Solutions is staffed with credentialed, experienced, reliable, and accurate coders who specialize in home health coding.

We at MedPro Healthcare Solutions understand the importance of timely submissions and are committed to provide a quick turnaround for our clients.

FAQs:

How do we access records?

It is completely up to you. We can access electronic medical records remotely through a secure VPN, or we can access paper records by faxing or scanning. Once we are granted access to the records, we can begin our services immediately. 

Why are your rates so low?

We recognize the struggle of the healthcare industry in today’s tough economic times. We want to assist agencies by optimizing reimbursement to survive in this constantly changing industry, while not being a burden. We feel that every agency deserves the ability to hire a consulting company while not worrying about the cost. 

What is your turnaround time?

We can turn records back over to you in as little as 24 hours. 

What if my clinician does not agree with your coder’s assignment?

Each coded assessment comes with a rationale explaining coding assignments and sequence. If the clinician is still not in agreement after reading the rationale, the clinician can simply call our toll free number and press 3 to speak with a consultant.

Coding Audits:

Coding is arguably the most vital component in calculating revenue. Thirty of the line items used in calculating the HHRG, deal with coding. Just one missing or incorrect code can cost you thousands of dollars.

We provide both prospective and retrospective coding audits.

Coding Education:

MedPro provides coding education to both clinicians and coders at an affordable rate. Our education is always approved by the BMSC for continuing education credits for the HCS-D. MedPro University is coming soon!

Contact us today for a free trial. Your first ten assessments are absolutely free!

If you have any questions, please feel free to contact us via email at info@mail.medprohealthcaresolutions.com or toll-free 1-800-501-6731.

Proper Use of M1024

If you are a newbie to home health coding or a seasoned professional, you may still have some trouble comprehending the proper use of M1024. What exactly is M1024? M1024 is used to prevent the loss of case mix points when an underlying case mix diagnosis is displaced by a V-code.
A diagnosis can only be placed in M1024 when there is a V-code listed in M1020a or M1022b-f. This slot is optional, therefore, agencies are not required to code a numeric diagnosis in M1024 if a V-Code replaces a case mix diagnosis code. Diagnoses listed in M1024 can only be a case-mix diagnosis that is resolved or a diagnosis that is part of one of the case-mix loss groups. The case-mix loss groups are Diabetes, Skin 1, and Neuro 1. If a V code is listed as primary and it is displacing a diagnosis in one of these categories, the diagnosis should be listed in M1024a and also in M1022. The diagnoses are termed case-mix loss groups because the diagnosis are given more points when reported as a primary diagnosis opposed to a secondary diagnosis.
Use the following guidelines to help you determine whether or not you should place a diagnosis in M1024a:

  1. *M1020 (primary diagnosis) is an approved V-Code
  2. The V-code displaces a numeric case-mix diagnosis that is resolved
  3. If the numeric case mix diagnosis is not resolved, it is included within on of the HH PPS case-mix loss groups:
    • Diabetes
    • Skin 1-Traumatic wounds, burns, and post-operative complications
    • Neuro 1-Brain Disorders and Paralysis

*In order to determine whether or not the V code which is displacing a case-mix diagnosis is an approved V code, you need to refer to this V Code Table. (If the V code in question is not listed in this table, there is no need to enter a diagnosis in M1024)

Coding Pressure Ulcers

Pressure Ulcers (aka decubitus ulcers) are one of the most common reasons for home healthcare services. Coding for a pressure ulcer requires two codes: A code to identify the location of the pressure ulcer (707.0x) and a code to identify the stage of the pressure ulcer (707.2x).

Pressure ulcer stages are based on severity, which is designated by stage I-IV and unstageable. Ulcer staging should be based on the ulcer’s deepest visible anatomical level. Review the history of each pressure ulcer in the medical record. If the pressure ulcer has ever been classified at a deeper stage than what is observed now, it should continue to be classified at the deeper stage.

When a pressure ulcer is covered with slough, eschar, or a non-removable dressing, these ulcers are coded as unstageable (707.25). The following ulcers are also coded as unstageable:

  • pressure ulcers treated with a skin graft
  • pressure ulcers treated with a muscle graft
  • DTI (deep tissue injury) not due to trauma

If a pressure ulcer is treated with a muscle graft Aftercare Skin Surgery is coded followed by the location of the pressure ulcer (707.0x) preceded by unstageable pressure ulcer code (707.25).

If a patient is reported to have bilateral pressure ulcers of the same site and both ulcers are documented to be the same stage, only one code for the site and one code for the stage should be assigned.

However, if a patient is reported to have bilateral pressure ulcers of the same site but with different stages, one code is assigned for the site and one code for each stage should be assigned. The highest stage should be listed first.

Welcome to In the Know

Stay in the Know with MedPro

In the Know is a blog published by MedPro Healthcare Solutions.  We are devoted to home health coding by  providing coding and auditing services, education and tips to those in the home health industry.  .  Please email us if you have any questions or comments.  Thank you for visiting.