The highly acclaimed CEU-approved national online healthcare publication, BC Advantage Magazine, featured two articles “Two Common Knee Ligament Injuries and Their ICD-10 Codes” and “Risk Adjustment and HCC Coding – A Look at Best Practices ” by Outsource Strategies International (OSI) – a Managed Outsource Solutions service – in February 2021. The article was published in the Coding Category.
The article titled, “Two Common Knee Ligament Injuries and Their ICD-10 Codes” looks at two common types of knee ligament injuries and their related ICD-10 codes.
The two knee ligament injuries are those occurring to the Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL). The former refers to a tear or sprain of the anterior cruciate ligament (ACL), one of the key ligaments in the knee joint. This ligament that connects the bottom of the thighbone (femur) to the top of the shinbone (tibia) helps stabilize your knee joint. ACL injury most commonly occurs during sports activities such as soccer, basketball, football and downhill skiing that involve sudden stops or changes in direction, jumping and landing, which can put additional stress on the knee. The PCL, which is located at the back of the knee, connects the femur (thighbone) to the tibia (shinbone) and keeps the tibia from moving backwards too far. PCL injury happens mostly during motor vehicle incidents and during involvement in contact sports such as football and soccer.
Other topics discussed in this comprehensive article include: symptoms and diagnosis of ACL and PCL. It also discusses how to document the condition and the ICD-10 codes to report these injuries under different circumstances.
“Risk Adjustment and HCC Coding – A Look at Best Practices” discusses risk adjustment – a method used to offset the cost of providing health insurance for people with chronic health conditions who represent a relatively high risk to insurance companies – and the Hierarchical Condition Category (HCC) method to calculate those risk scores.
HCC coding helps “communicate patient complexity and paint a picture of the whole patient”, according to the American Academy of Family Physicians. Accurate HCC coding enables better health management and helps proper assessment of quality and cost performance for accurate reimbursements from Medicare Advantage plans. Non-adherence to the risk adjustment and coding requirements for Medicare Advantage can adversely impact medical practice/hospital revenue.
The article provides a comprehensive view of HCC coding – the common HCC codes, key considerations for accurate HCC coding, and best practices for HCC coding.
Established in 2002, OSI is a healthcare business process outsourcing company based in the U.S. The company provides end-to-end medical billing and coding services and practice management solutions for all medical specialties, from front office administrative management to back office coding, billing and collections. They serve medical practices, physicians, dental practices, and dentists. OSI’s medical billing team is also specialized in insurance eligibility verification and authorization.
OSI’s team of skilled AAPC-certified coders have a strong understanding of HCC coding, ICD-10-CM and CPT requirements and procedures, and stays up-to-date with coding changes, payer-specific documentation requirements, and state and federal regulations.
This medical billing company strives to leverage their medical billing and coding expertise to provide customized solutions for all medical specialties. The company’s experience and expertise have been recognized by BC Advantage Magazine, the largest independent resource provider in the industry for medical coders and billers, healthcare auditors, practice managers, compliance officers, and clinical documentation experts.
The magazine’s online medical coding article section had earlier featured two other articles from OSI: “ICD-10 Codes for Some of the Worst Epidemics in the U.S.” on February 19, 2020 and “Thanksgiving-Specific Foodborne Illnesses – Types, Symptoms, and ICD-10 Codes” on November 26, 2019.