Rhonda Butler

We’re celebrating 40 years of 3M Health Information Systems (HIS)! We couldn’t do it without our employees’ hard work and dedication.  Working at 3M HIS can undoubtedly be fun. From […]

The diagnosis portion of the September ICD-10 Coordination and Maintenance (C&M) meeting, hosted by the National Center for Health Statistics (NCHS), of the Centers for Disease Control (CDC), was marked […]

The day I delivered the fiscal year 2024 ICD-10-PCS update files to the Centers for Medicare & Medicaid Services (CMS) for posting, it so happened that one of my favorite […]

It was Tuesday, March 7, and it (most likely) happened something like this … a coder or coding manager was watching the ICD-10 Coordination & Maintenance (C&M) virtual meeting on […]

If there is one word that captures what many of us want to focus on in 2023, I think “balance” is a good candidate. From global issues like the climate […]

The September ICD-10 Coordination and Maintenance Committee (C&M) meeting held via Zoom Sept. 13 and 14 had a lopsided agenda—only four topics for proposed changes to the ICD-10-PCS procedure classification […]

It happens every year around Memorial Day: The ICD-10 procedure code updates are posted on the  Centers for Medicare & Medicaid (CMS) website just as people are thinking summer thoughts. […]

The March ICD-10 Coordination and Maintenance Committee (C&M) meeting, held via Zoom March 8 and 9, had 60 topics on the combined agenda—29 topics for proposed changes to the procedure […]

In December I posted a blog on the “new and improved normal,” discussing the April 1 ICD-10-CM/PCS update added to the schedule beginning in 2022. Two updates a year instead […]

Last year, the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) jointly finalized a proposal to make the April 1 update of ICD-10-CM/PCS […]

The latest ICD-10 Coordination and Maintenance Committee (C&M) was held virtually Sept. 14-15. First on the agenda, the Centers for Medicare and Medicaid Services (CMS) announced its final joint decision […]

The first draft of this blog was an exhaustive (and exhausting) summary of the actual changes to the FY 2022 ICD-10-PCS posted recently on the Centers for Medicare and Medicaid […]

The latest ICD-10 Coordination and Maintenance Committee (C&M) meeting gave us one more unprecedented thing in this time of unprecedented things—the combined agenda was the largest ever. The two-day virtual […]

In response to the national emergency declared for the COVID-19 pandemic, the CDC has implemented six new ICD-10-CM diagnosis codes and CMS has implemented 21 new ICD-10-PCS procedure codes for […]

Hopefully October 1 came and went for you as normally as could be expected—considering we are beginning fiscal year 2021 during the biggest health care emergency of our lifetimes. Typically, […]

Update: On August 6, CMS added two files to the ICD-10-PCS COVID-19 update posted on July 30. They are: 1) the xml file icd10pcs_tables_2021.xml containing the combined complete FY 2021 […]

The ICD-10-PCS update for FY 2021 was posted on May 28. Thankfully, there has been nothing unusual about the update cycle for ICD-10-PCS. There have been no interim updates and […]

Time is seriously weird stuff. 2020 so far has had that dream/nightmare quality that is somehow fast and slow at the same time. My memory of February, only four months […]

March 23 update: CMS has posted a one-page summary document outlining the ICD-10 MS-DRG code assignment and definitions for the new COVID-19 code, effective for discharges on or after April 1, […]

One of the many wonderful things about the post-Google information age is that, with no appreciable time or effort, you can pose a question and see what’s out there. The […]

Classification systems like ICD-10-CM and ICD-10-PCS are all about trade-offs—balancing the ongoing need for new levels of detail with the increasing complexity of the classification. PCS has its own unique […]

Way back in the early days of ICD-10-PCS development, “root operation” was defined as “the objective of the procedure.” As definitions go, “the objective of the procedure” is about a […]

For those of us facing “maturity,” when we were growing up the year 2020 seemed an impossibly exotic thing, the stuff of science fiction. Time has flown like a freaking […]

Part one of this two-part blog was a high-level summary of two major areas of focus in the proposed MS-DRG changes: the MCC/CC designations and the “unrelated OR DRGs. This […]

If there is a theme to this year’s proposed MS-DRG changes in the IPPS proposed rule, it is “ICD-10 Data.” Now that two years’ worth of ICD-10 coded MedPAR data […]

In my last blog, I recommended checking out excerpts from the March ICD-10 Coordination and Maintenance meeting. Those excerpts were written proposals for ICD-10 codes describing SDOH (social determinants of […]

I’ve got a two-part (maybe three-part) homework assignment for you: Read a pair of proposals for new ICD-10 codes, presented at the March C&M meeting. They are each two pages […]

AHA Coding Clinic’s Editorial Advisory Board (EAB) held its two-day winter session in February, and I participate on the EAB as part of 3M’s contract with CMS. As I was […]

Geek alert: If you are one of those people who don’t want to know how sausages and legislation are made, you may want to skip this blog. It is pretty […]

I highly recommend watching Donna Pickett’s ICD-11 presentation, given at the September 12 morning session of the ICD-10 Coordination and Maintenance (C&M) meeting in Baltimore. The link to the YouTube […]

I have said it before—I am not a fan of the term “correct coding” because it can so easily be misconstrued as being about individual interpretations of correct and incorrect, […]

In my most recent blog, I discussed in general why the capacity of ICD-10-PCS has limits, and how multi-axial structure and hierarchy together define those limits. This time I’m going […]

At the March C&M meeting, we heard the heartening report that people no longer get all in a dither about the number of ICD-10 codes. That is super good news. […]

Like most of you who participated in the ICD-10 Coordination and Maintenance Committee held last week at CMS headquarters in Baltimore, I watched the live webcast on YouTube. I also […]

Note: I started this blog on Monday morning, when an agreement to end the shutdown was still being worked out. Now that government is funded, the blog looks like old […]

Like so many of you in the past week or so, I am on an airplane, going to visit family. So far I’ve been spending the flight alternately staring at […]

Coding is fundamentally a balancing act, a delicate, high-wire dance intended to get useful data from the medical record that can be widely shared in health care. It happens at […]

In my last blog, I talked about the trade-offs between lumping and splitting as they apply to the annual update of the ICD-10-CM/PCS classification systems. This time I am going […]

You may have heard the terms lumping and splitting applied to medical records coding, or maybe to the analysis of coded data. Whether we’re producing coded data or analyzing it, […]

The ICD-10-PCS FY 2018 update was posted on the CMS website in the second half of May, and contains the changes to PCS that go into effect on October 1. […]

In my last blog I said that the ICD-10-PCS root operations are not created equal—some are narrowly defined, and some have “wiggle room” in their definitions. By “narrowly defined,” I […]

Root operations are core concepts at the heart of the ICD-10-PCS classification (PCS for short). Root operations are not created equal—some are more narrowly defined than others. It would be […]

When coders say “coding is an art,” they don’t mean art—they don’t imagine themselves creating little medical record haiku. Describing coding as an art is a way of saying that […]

Codes and coding are back in the headlines. A recent in-depth New York Times article examines the labyrinth of coding and billing, and asserts that coding is one reason for […]

In my last blog, my inner imp and I tussled over whether ICD-10 codes are still worth the trouble. Bottom line—they are, because codes allow us to highlight key pieces […]

I don’t know about you guys, but around this time of year, when it seems like spring will never come again, ever, the restless imp in my head starts questioning […]

Dr. Robert Mullin passed away on Friday, January 20. A sad day for all of us. Dr. Bob was one of the clearest, toughest, most visionary thinkers it has ever […]

“Life goes on, having nowhere else to go.” – Diane Ackerman, The Moon by Whale Light These days, in the aftermath of the most discomfiting election season of my life, […]

Beginning October 1, the grace period ends for Medicare part B ICD-10 diagnosis coding. For those of you who heard the news but not the details, here is a quick […]

My years of posting blog diatribes against the politics behind the ICD-10 implementation saga may have sent a confusing message regarding government (as distinguished from politics), so I would like […]

Warning: This blog may be pretty heavy going for non-coders. Possible side effects include, but are not limited to, uncontrolled eye-rolling, heavy-sigh-induced hypoxemia, facial tics and persistent vegetative state. If […]

In an earlier blog, I said it is a common misconception that ICD-10-CM/PCS is brand spanking new. But it isn’t. It is unused. Just as putting meat in the freezer […]

In part 2 we talked about the Mississippi Mud rule, an informal notion about how the device works in PCS that can get you mired in confusion when it comes […]

In the first part of this blogatribe, we got the basic principle of the device value under our collective belt. The principle, recapped: the sixth axis is a way of […]

A device value and a device are not the same thing The heading for each axis in the seven axis PCS table is self-referential. What does that mean? It means […]

The word “matrix” has lots of definitions, and three of the most common ones all describe an aspect of ICD-10-PCS (PCS for short). I know…why bother with yet another blog […]

Out with the old, etc. I hope 2015 saw the end of some ICD-10 habits we need to break—and 2016 is the beginning of […]

It seems that wishes are not just for fairy tales, they can come true after all. So far, it looks like the wish for an uneventful ICD-10 transition is a […]

Keep calm and carry on…that was the title of the first thing I ever wrote, in early 2010, about the hype surrounding ICD-10. Less than six months after the CMS […]

Ten years ago I had the chance to make my job portable and work from home, so I moved to a small town called Florence that I “discovered” on the […]

In Neil Stephenson’s latest novel Seveneves, one of the main characters says, “politics” is a word nerds use when they feel impatient about the human realities of an organization. When […]

A system for classifying knowledge is a framework for organizing information. It is usually a vastly simplified model of some aspect of reality as we understand it, like the periodic […]

This blog assumes you have read part 1, so if you haven’t, see you back here in a few minutes. Part 2 is for those of you in specialties where […]

Did you end up here because you haven’t done squat about ICD-10, and you googled “ICD-10 cheat sheet?” Fantastic. Come on in, there’s plenty of room. I could get all […]

If you have the slightest inclination to freak out about ICD-10 because change makes you nervous, please ignore this blog. Okay, now for the rest of you: the code sets […]

If no further weird politics intervene, we will be able to use ICD-10 codes for real, finally, beginning October 1, 2015. This experience has been emotionally draining for everyone. For […]

Yes, there are ICD-10 codes for exceedingly rare ways to die, and yes, they are easy to parody. This does not matter at all, since not many people are admitted […]

What makes a species distinct enough that it gets its own unique name? In my last blog, I discussed the taxonomy of living things developed by Carl Linnaeus in the […]