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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.”

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Septic Shock

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 septic shock. Septic shock generally refers to circulatory failure associated with severe sepsis and therefore represents a type of acute organ dysfunction.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Asthma

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 Asthma.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Neoplasm of the Meninges

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 Neoplasm of the Meninges.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Hyperparathyroidism

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 Hyperparathyroidism.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Metastatic Cancer/ Secondary Malignant Neoplasm

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 Metastatic Cancer/Secondary Malignant Neoplasm.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Myasthenia Gravis

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 myasthenia gravis.

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Clinical Documentation Improvement
  
Provider Alerts - Coding - Policy, Billing, or Coverage Update - 2023
Acceptable Procedure Code/Modifier Combinations

Effective Sept. 1, 2023, Healthfirst is updating internal systems to deny procedure code/modifier combinations that are specifically flagged as invalid or inactive. These changes are based on New York State Medicaid (NYSM), American Medical Association (AMA), and Centers for Medicare & Medicaid Services (CMS) guidelines.

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Coding
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Major Depressive Disorder

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 Major Depressive Disorders.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Pulmonary Fibrosis

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 pulmonary fibrosis.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Spinal Cord Injury

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 spinal cord injury.

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Clinical Documentation Improvement
  
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