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Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Inflammatory Bowel Disease

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for inflammatory bowel disease (IBD).

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Clinical Documentation Improvement
  
Provider Alerts - Coding - Claims & Billing - Policy, Billing, or Coverage Update - 2022
Coding Instructions for Co-Surgeons and Team Surgeons

Healthfirst follows the Centers for Medicare & Medicaid Services (CMS) guidance for the use of co-surgeon (-62) and team surgeon (-66) modifiers with claim submissions.

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Billing
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Alcohol Disorders

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for alcohol disorders.

Open document
Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Human Immunodeficiency Virus (HIV/AIDS)

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for common types of HIV/AIDS.

Open document
Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Huntington's Disease

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst – specifically for Huntington’s disease.

Open document
Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Chronic Pancreatitis

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst specifically for common types of Chronic Pancreatitis.

Open document
Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Lung Cancer

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for common types of lung cancer.

Open document
Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2022
Documentation and Coding: Multiple Myeloma

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for multiple myeloma.

Open document
Clinical Documentation Improvement
  
Coding - Policy, Billing, or Coverage Update - 2024
Medicare Physician and Practitioner Providers - Medical Record Request for Calendar Year 2022 (CY22) Part C Improper Payment Measure (Part C IPM)

This request is based on diagnosis data submitted to the Centers for Medicare & Medicaid Services (CMS) as a result of services you provided to MA beneficiaries during calendar year 2021 (CY21). The purpose of this request is to validate diagnoses that were sent to CMS to determine health status-adjusted payments under risk adjustment.

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Risk Adjustment Data Validation Audit
  
Coding - Policy, Billing, or Coverage Update - 2024
Medicare Hospitals - Medical Record Request for Calendar Year 2022 (CY22) Part C Improper Payment Measure (Part C IPM)

This request is based on diagnosis data submitted to the Centers for Medicare & Medicaid Services (CMS) as a result of services you provided to MA beneficiaries during calendar year 2021 (CY21). The purpose of this request is to validate diagnoses that were sent to CMS to determine health status-adjusted payments under risk adjustment.

Open document
Risk Adjustment Data Validation Audit
  
Coding - Practice Guidelines and Tips - 2024
Documentation and Coding: Sepsis, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, on services submitted to Healthfirst—specifically for sepsis.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Severe Sepsis

This tip sheet will offer guidance on how to submit a diagnosis code with greater specificity for coding Severe Sepsis. Two codes, at a minimum, are needed to report severe sepsis without septic shock. Chapter‑specific guidelines state, “First code for the underlying systemic infection, followed by a code R65.20, Severe sepsis. If the causal organism is not documented, assign code A41.9, Sepsis, unspecified organism, for the infection. Additional code(s) for the associated acute organ dysfunction are also required.”

Open document
Clinical Documentation Improvement
  
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