What is Risk of Mortality (ROM)? Risk of Mortality (ROM) in medical coding is a clinical severity measure used in healthcare coding and reporting that estimates the likelihood a patient will die during a hospital stay. ROM is typically assigned using coding systems...
What is Severity of Illness (SOI)? Severity of Illness (SOI) in medical coding is a classification system used in healthcare reporting that measures the extent of a patient’s illness. It reflects how sick the patient is and how much hospital resources may be required...
Understanding MCC and How It's Used In medical coding, MCC stands for Major Complication or Comorbidity. It is a classification used in the ICD-10-CM and MS-DRG (Medicare Severity Diagnosis-Related Group) systems. MCCs represent conditions that are severe and...
Read the Case Carefully Skim the entire scenario once to understand the big picture (inpatient, outpatient, ED, surgical, etc.). Underline or highlight key clinical details: Primary diagnosis Secondary diagnoses/comorbidities Procedures performed Patient status (new...
Pro fee coding, short for professional fee coding, refers to the process of assigning medical codes to professional services provided by physicians and other qualified healthcare professionals. Pro fee coding focuses on capturing and billing for the provider’s...
What Is CMS in Medical Coding? The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services (HHS) that plays a critical role in healthcare administration and policy. In the context of medical...
What Is a Manifestation Code in Medical Coding? In medical coding, accuracy is crucial for proper diagnosis reporting, insurance reimbursement, and compliance. One specific type of diagnosis code that often confuses new coders is the manifestation code. Understanding...
Trauma Registry Coder Guidelines & Tips A trauma registry is a specialized database that collects, stores, and analyzes information on patients who sustain traumatic injuries. Accurate and complete medical coding of trauma registry is critical for quality...
Pneumonia Coding & Billing – Guidelines & Tips Pneumonia is a common and potentially serious respiratory infection that medical coders frequently encounter. Accurate coding and billing are essential to reflect the severity of illness, ensure compliance with...
What Is Medical Necessity in Medical Coding & Billing? Medical necessity is a cornerstone of accurate medical coding and billing. It determines whether a service, procedure, or supply is reasonable, necessary, and appropriate based on a patient’s medical...