In this episode, Kristen Eglintine, BESLER’s Senior Manager of Revenue Integrity Services of Coding and Projects, provides us with a glimpse into BESLER’s next free webinar, Coding Clinic Q4 2024: Updates and Insights, presented live on Wednesday, March 19, at 1 PM ET.
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Learn how to listen to The Hospital Finance Podcast® on your mobile device.Highlights of this episode include:
- Background on coding clinics
- How and what coding clinic are used for
- The importance of coding clinics’ advice
- How this webinar will be different from BESLER’s previous webinar on Coding Clinic in 2023
- Preview of the topics that will be covered
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back Kristen Eglintine, BESLER’s Senior Manager of Revenue Integrity Services of Coding and Projects. In this episode, Kristen will provide us with a glimpse into BESLER’s next free webinar, Coding Clinic Q4 2024: Updates and Insights that we’re presenting live on Wednesday, March 19, at 1 PM Eastern Time. Welcome back and thanks for joining us today, Kristen.
Kristen Eglintine: Thank you, Kelly. This is our first time talking in 2025. We have a great topic to talk about, one that’s close to my heart and I have a ton of respect for it as a coder. So, I’m very excited to be here. So, thank you for having me.
Kelly: Thanks for coming back. Well, let’s go ahead and jump in. So, in 2023, BESLER hosted a similar webinar on coding clinics. Coders, CDI specialists, HIM, auditors, and others are all familiar with coding clinics, but can you provide us with some background on coding clinics?
Kristen: Absolutely. So, Coding Clinic, it’s a quarterly publication by the American Hospital Association. We refer to AHA’s Central Office. The AHA’s Central Office serves as the official U.S. Clearinghouse on medical coding for the proper use of ICD-10 CM and PCS codes, and all level one and two HCPCS for physicians, other health professionals, and for hospitals. Since 1984, the AHA Central Office began publishing these quarterly publications known as the AHA’s Coding Clinic. And that is, again, for ICD-10 CM codes, ICD-10 PCS codes, and for HCPCS. And then even though the AHA publishes the quarterly publication, they do have a formal cooperative effort between AHIMA, the CDC, and CMS for recommendations on revisions or modifications to this classification system.
Kelly: Thank you for providing us with that background. Can you elaborate on how and what coding clinic is used for?
Kristen: So, both AHA’s coding clinic for the ICD-10 codes, whether they’re CM or PCS, and then the AHA’s Coding Clinic for HCPCS, they both provide expert guidance on coding practices and interpretations. The coding advice in the quarterly publication delivers insights to educate providers, coders, insurers, and others in the field on the proper use of ICD-10 codes and HCPCS. Coding clinics answer questions on code assignment and sequencing of codes, and it serves as a current reference on regulatory and other requirements for reporting diagnostic and procedural information from medical records. But in simplistic terms, coding clinics provide coding guidance for coders. We rely on it heavily.
Kelly: Thank you for that explanation. So, Kristen, would you clarify the importance of coding clinics’ advice compared to maybe some other resources that coders rely on for guidance?
Kristen: As we know, coders rely on multiple pieces of information as references. We rely on the alphabetic index, our tabular list, official coding guidelines, and AHA’s coding clinic for reporting the correct diagnosis or procedure code. However, it is important to understand that coding clinic’s advice trumps all other resources. The coding clinic is the approved resource to update and clarify the use of ICD-10 CM and PCS and HCPC. Their advice is not optional, and it takes precedence over guidelines. CMS’s affirmation of coding clinic as the official source of coding information is noted in the federal register from August 27th, 2009.
Kelly: So, it seems like it would be rather important.
Kristen: Yeah.
Kelly: Yeah. So how will this webinar be different from BESLER’s previous webinar on Coding Clinic in 2023?
Kristen: Our upcoming webinar will be similar in format, but different in the material presented. Every quarter’s publication focuses on new questions submitted or new codes released. So, while the release of a new coding clinic can feel familiar, there’s always great anticipation for the new information and guidance. Today more than ever, coders must possess an understanding of anatomy, terminology, coding guidelines, and coding clinic to report the most accurate codes. And because there is new material released quarterly, coders have the responsibility to be aware of this tool and how to use it. So, it’s our hope presenting webinars like this on coding clinic guidance makes the coders job a bit easier.
Kelly: I would certainly think so. So can you provide us with a preview of the topics that will be covered on this webinar?
Kristen: The fourth quarter, coding clinics from 2024, was quite large due to 2025 ICD-10 codes going into effect at the beginning of the quarter. We did select a few topics that we felt were relevant and have, what I would say, like the so what characteristic. And what I mean by that is that we have an infinite amount of information at our fingertips daily. Some even say we’re in an information overload state. So, we chose and will present topics that mean something to coders that have a purpose and an effect. So, we’ll discuss new codes that have a financial impact on an account, or we’ll discuss new codes that provide more specificity of a patient’s medical condition. Wound dehiscence is the first topic we’ll cover. So wound dehiscence is a surgery complication where a surgical incision reopens or separates. It’s a serious medical condition and then capturing this can help mitigate potential risks associated with postoperative care and it’s important to code it correctly. The T-code used to report this complication is ACC and can impact DRG assignment and reimbursement. Other topics covered will be obesity designated by class, serotonin syndrome, and eating disorders, which I do just want to interject and mention here that Coding Clinic for the first quarter of 2025 was released in the last day or so, and they are clarifying one of the new codes for obesity designated by class.
So, it was obesity designated by Class Type 3, and they are issuing a clarification on that and how that codes with morbid obesity. So be on the lookout for that.
Kelly: Sounds like it’s going to be a packed webinar. You mentioned one of these. So, eating disorders are on the rise. How does this coding clinic touch on this very relevant and important topic?
Kristen: Great question. So, each quarterly release includes case studies and examples from actual patient records, helping coders apply the correct codes in real-world situations, such as addressing new codes for eating disorders. So let me share this great example with you. As you mentioned, they are on the rise. The prevalence of eating disorders has doubled in the last 20 years. In the early 2000s, about 3.5% of the population suffered from an eating disorder. But by 2013 to 2015-ish, that statistic was up to almost 8%. This increases alarming, and therefore, eating disorders are getting the much deserved attention that they need. In fact, we just celebrated Eating Disorders Awareness Week, and that took place at the end of February. And according to the National Eating Disorder Association, eating disorders are considered a public health issue. They have the second highest mortality rate among mental health conditions. One person dies from an eating disorder every 52 minutes. They do not discriminate. So, anyone, regardless of age, gender, identity, race, religion, sexual orientation, body shape, and weight can be affected by an eating disorder. That’s what makes this topic so relevant. Coders are going to see more of this condition over and over again.
So, with the new code set, the fiscal year 2025, ICD-10 CM, there were several new codes that were added to address the different types of eating disorders and their severity. An example would be there are new codes in the subcategory F50.0 for anorexia. There are also new codes for binge eating. And then all of these codes do require a fifth or sixth character to identify the severity of the condition. So not only are we getting more specificity, we’re getting an increase in severity as well. Bringing that back to the real world, so when someone has a mental health diagnosis added to their chart, a more specific and accurate code can help make sure the person is receiving the best treatment plan for their condition, and that also impacts future care. And that is all I had to touch on today for the webinar. I’d like to thank everyone for joining us today. This podcast is just an introduction to our upcoming webinar. That would greatly help any coding professional out there. As Kelly mentioned before, the webinar is scheduled for Wednesday, March 19, at 1 PM Eastern Standard Time. I strongly encourage and invite everyone to attend for a more detailed review of coding guidance that was released in AHA’s fourth quarter coding clinic from 2024.
Kelly: Well, thanks, Kristen. Thanks for sharing all your insights into this Webinar that we have, like you said, on March 19, at 1 PM Eastern time. And as a bonus, you can earn CEU. Thanks again, Kristen.
Kristen: Thank you.
Kelly: And thank you all for joining us for this episode of the Hospital Finance Podcast. Until next time…
[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.
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