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Icd 10 code for sss with pacemaker

2021 ICD-10-CM Diagnosis Code I49

  1. Sick sinus syndrome 2016 2017 2018 2019 2020 2021 Billable/Specific Code I49.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM I49.5 became effective on October 1, 2020
  2. g back to 1993, was that once a pacemaker was placed for SSS, you only coded the pacemaker's presence. This advice was updated on page 33 of the edition issued for the first quarter of 2019, with the guidance that SSS is considered to still be present and is a legitimate, reportable chronic.
  3. Assign code V53.31, Fitting and adjustment of other device, Cardiac device, cardiac pacemaker, as an additional code assignment. A code is not assigned for sick sinus syndrome when it is being controlled by the pacemaker and no problems are detected during the check
  4. ICD-10 Mapping . The table below demonstrates the ICD-9 to ICD-10 code mapping of SSS and pacemaker status. ICD-9 Code ICD-10 Code 427.81 Sinoatrial node dysfunction I49.5 Sick sinus syndrome V45.0 Cardiac device in situ Z95.0 Presence of cardiac pacemaker . Per Mayo Clinic, sick sinus syndrome (SSS) is the nam
  5. Icd 10 Code For Sss With Pacemaker Coupons, Promo Codes 06-2021. Great offers from www.couponupto.com AHA Coding Clinic ® for ICD-9 - 2010 Issue 3; Ask the Editor Pacemaker Interrogation with Controlled Sick Sinus Syndrome.Coding Clinic, Fifth Issue 1993, page 12, advised that when sick sinus syndrome (SSS) is controlled by a pacemaker, no code assignment is required if no attention or.
  6. AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS - 2019 Issue 1; Ask the Editor Sick Sinus Syndrome Controlled with Implanted Cardiac Device. If a physician sees a patient (in any setting) and evaluates the patient's sick sinus syndrome (SSS) or other significant heart rhythm abnormality, is it appropriate to assign a code for the specific condition in addition to the code for the presence.

Sick sinus syndrome (SSS) ICD-10-CM Tips and resources for coders When a patient with sick sinus syndrome (SSS) has a cardiac device that is being used as part of the management of SSS, it is appropriate to code both the sick sinus syndrome and the presence of the cardiac device. I49.5For example, a coder may assign codes Sic ICD-10-CM code B20 is for Human immunodeficiency virus (HIV) Even with the presence of the pacemaker, the SSS is still present (albeit managed/monitored); it has not been cured. Also, follow the ICD-10-CM Official Coding & Reporting Guidelines for other diagnoses.

Atrial Fibrillation and Pacemakers: Can Both be Coded

Presence of cardiac pacemaker 2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt Z95.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM Z95.0 became effective on October 1, 2020 I49.5 — sick sinus syndrome Z95.0 (no HCC) — presence of cardiac pacemaker Resources 1 Sick sinus syndrome —Genetics Home Reference NIH. (n.d.). Retrieved November 26, 2019, from ghr.nlm.nih.gov 2 Sick sinus syndrome. Retrieved November 26, 2019 from mayoclinic.org 3 AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, Volume 6 Coding tips: • SSS controlled by pacemaker - For patients with SSS that is controlled by their pacemaker, coding guidelines advise no code assignment is required for the SSS. Instead, a code may be assigned for pacemaker presence, or for attention to the pacemaker (Z45.010, Z45.018). • SSS s/p pacemaker, additional treatmen Group 1 CPT codes apply to Groups 1 and 2 ICD-9-CM and ICD-10-CM Codes. 05/01/2016: R1: The provisions in this article will be applied to dates of service on or after May 1, 2016. ICD-10-CM code was revised from I44.2 to I44.1 in the following indication in the Diagnosis Codes (ICD-9-CM /ICD-10-CM) (Attest with Modifier - KX) section

Also know, do you code sick sinus syndrome with pacemaker? ICD-10 Code 0 Presence of cardiac pacemaker Per Mayo Clinic, sick sinus syndrome (SSS) is the name for a group of heart arrhythmias in which the sinus node, the heart's natural pacemaker, doesn't work properly ICD-10-CM Coding Workbook for Cardiology Specialty coding guidance for ICD-10-CM 201 AHA Coding Clinic ® for ICD-9 - 2010 Issue 3; Ask the Editor Pacemaker Interrogation with Controlled Sick Sinus Syndrome. Coding Clinic, Fifth Issue 1993, page 12, advised that when sick sinus syndrome (SSS) is controlled by a pacemaker, no code assignment is required if no attention or treatment is provided to the condition or the device

I49.5 is a billable diagnosis code used to specify a medical diagnosis of sick sinus syndrome. The code I49.5 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. The ICD-10-CM code I49.5 might also be used to specify conditions or terms like complete deafness. Sick sinus syndrome (SSS) ICD-10-CM . Tips and resources for coders . When a patient with sick sinus syndrome (SSS) has a cardiac device that is being used as part of the management of SSS, it is appropriate to code both the sick sinus syndrome and the presence of the cardiac device. For example, a coder may assign codes I49.5 Sic

In ICD-10-CM, there are four codes to report atrial fibrillation: I48.91 is used to report atrial fibrillation when no further specificity is available I48.2 is used to report atrial fibrillation when specified as chronic or permanent (Will be expanded 10/1/19) I48.0 is used to report atrial fibrillation when specified as paroxysma Code Description Code # of ICD-10 code characters pacemaker and document presence of cardiac pacemaker (Z95.0). This applies to SSS Atrial fib has resolved Deep Vein Thrombosis, Chronic (see D68.8 Other specified coagulation defect, below Similar to ICD-9-CM, pacemaker insertion in ICD-10-PCS requires a code for placement of the generator as well as insertion of the lead(s). Measurement: While this root operation is in the medical and surgical-related section, it is the choice for cardiac catheterization procedures ICD-10-CM Code. I49.5. Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis. I49.5 is a billable ICD code used to specify a diagnosis of sick sinus syndrome. A 'billable code' is detailed enough to be used to specify a medical diagnosis

Wiki - ICD 9 Coding SSS when a pacemaker is present

Yes, also code the SSS diagnosis (I49.5) along with the code for the presence of pacemaker device (Z95.0). Even with the presence of the pacemaker, the SSS is still present (albeit managed/monitored); it has not been cured. Also, follow the ICD-10-CM Official Coding & Reporting Guidelines for other diagnoses. Group 2: Codes were deleted as the NCD does not address replacement of pacemaker generators. CPT codes 33227, 33228, 33229, and 33233 were therefore not addressed in this coding article. 05/01/2016: R1: Under Article Text the titles of all sections were revised. Under Group I and Group II Diagnosis Codes adde Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (NCD 20.8.3) Page 2 of 6 UnitedHealthcare Medicare Advantage Policy Guideline Approved 04/14/202

When a chronic condition exists but is managed by a medical device (e.g., a pacemaker or defibrillator), assign codes for both the underlying condition and the device. Read the full article. Get. ICD-10-CM 2021 Coding Guide™ from Unbound Medicine. Search online 72,000+ ICD-10 codes by number, disease, injury, drug, or keyword. Complete Product Information. Citation I49.5 - Sick Sinus Syndrome. ICD-10-CM, 10th ed., Centers for Medicare and Medicaid Services and the National Center for Health Statistics, 2018 • ICD-10 Code: I49.5 - Sick Sinus Syndrome. Acceptable Documentation for SSS with Pacemaker . Pacemaker interrogation is a routine computer evaluation of pacemaker function to verify the device is programmed accurately and to assess the battery and lead function. Once a pacemaker is in place, SSS will not be coded 50 year old female with SSS with pacemaker. Assessment: SSS with pacemaker. Also, on beta blockers for episodes of tachycardia. Stable with good control of sx. ICD-10 Code: I49.5 Sick Sinus Syndrome Plan: Continue meds My patient has sick sinus (tachy-brady) syndrome and a pacemaker. I can no longer code SSS per new coding rule I49.8 is a billable diagnosis code used to specify a medical diagnosis of other specified cardiac arrhythmias. The code I49.8 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. The ICD-10-CM code I49.8 might also be used to specify conditions or terms like.

A patient with sick sinus syndrome was admitted for initial insertion of dual-chamber pacemaker device into chest, open approach. Pacemaker leads were placed percutaneously in the right ventricle and right atrium. (4 codes) I49.5, 0JH606Z, 02H63JZ, 02HK3JZ ICD-10 Coding Final Review. 75 terms. tanaporn_jennifer. CPC PRACTICE EXAM 1 ANSWERS. Page 4 See page 2 for important information about the uses and limitations of this guide and page 25 for all third-party sources. continued from 1.1 Hospital inpatient diagnosis codes ICD-10-CM1 Descriptor I50.814 Right heart failure due to left heart failure I50.82 Biventricular heart failure I50.83 High output heart failure I50.84 End stage heart failur The following is a list of diagnosis codes that may be associated with VT, SVT, and PVI ablation procedures. The list is for illustrative purposes only. Refer to the Instructions for use supplied with a product for indications, contraindications, side effects, warnings, and precautions. ICD-10-CM. 1. Diagnosis Code ICD-10-CM. 1 . Diagnosis Code. Pacemaker evaluation should include interrogation of arrhythmia logs (looking for atrial and ventricular tachyarrhythmias), percentage of ventricular pacing, rate histograms, and automatic threshold checks performed by the pacemaker. ICD-10 Codes. sick sinus syndrome: 149.5. other specified cardiac arrhythmias: 149.8. supraventricular. CPT code above if medical necessity criteria are met: ICD-10 Diagnosis Codes ICD-10-CM diagnosis codes: Code Description I44.1 Atrioventricular block, second degree I44.2 Atrioventricular block, complete I45.5 Other specified heart block I49.5 Sick sinus syndrome R00.1 Bradycardia, unspecified Description Conventional Pacemakers

The following ICD-10 code has been deleted and therefore has been removed from the article: I48.1 The following ICD-10-CM codes have been added to ICD-10 code group 2 of the Article: I48.11 and I48.19. The text under (Additional) Diagnosis Codes (ICD-10-CM) Allowed by the NCD - Group II (Attest with Modifier - KX) has been revised to replace. ICD-10-PCS code characters Q1: When entering the following code OUT90ZZ, the application gives an error? ICD-10 codes do not include the letters O (oh) or I (eye) as these are easily mistaken for the numbers 0 (zero) and 1 (one). ICD-10 code OUT90ZZ should be entered as 0UT90ZZ and 0X6I0ZZ should be entered as 0X610ZZ AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS - 2016 Issue 4; New/Revised ICD-10-PCS Procedure Codes, Section 0-Medical and Surgical Intracardiac Pacemaker. A new Device value was added for a novel type of pacemaker. Intracardiac pacemakers are also known as leadless pacemakers and transcatheter pacemakers

Coding for Heart Arrhythmias. For The Record. Vol. 22 No. 21 P. 28. Heart rhythm problems occur when the electrical impulses in the heart don't function properly, causing the heart to beat too fast, too slow, or irregularly. Symptoms. A heart arrhythmia may not cause any noticeable symptoms and may be identified only during a routine medical. Sick sinus syndrome is the inability of the heart's natural pacemaker (sinus node) to create a heart rate that's appropriate for the body's needs. It causes irregular heart rhythms (arrhythmias). Sick sinus syndrome is also known as sinus node dysfunction or sinus node disease. The sinus node is an area of specialized cells in the upper right. Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed . ICD-10 Procedure . 02HK3NZ. Insertion of intracardiac pacemaker into right ventricle, percutaneous approach . ICD-10 Diagnosis . All diagnose • 33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial • 33207 ventricular • 33208 atrial and ventricular The NCD does not address replacement of pacemaker generators. CPT codes 33227, 33228 and 33229 or 33233 are therefore not addressed in this coding article

Icd 10 Code For Sss With Pacemaker - 06/202

Sick Sinus Syndrome Controlled with - Find-A-Cod

As there is no ICD-10-AM index entry we've chosen I49.8 Other specified cardiac arrhythmias in the meantime, but would like confirmation. Response Based on clinical advice chronotropic incompetence is usually due to sinus node dysfunction and the clinicians consulted have advised the most appropriate diagnosis code to assign is I49.5 Sick sinus. Nielsen JC, Thomsen PE, Højberg S, et al. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome. Eur Heart J 2011; 32:686. Alboni P, Menozzi C, Brignole M, et al. Effects of permanent pacemaker and oral theophylline in sick sinus syndrome the THEOPACE study: a randomized controlled trial. Circulation 1997. ICD-10 Code for Vasovagal Reaction. This allows gravity to keep blood flowing to your brain. Sick sinus syndrome SSSalso called sinus dysfunction, or sinoatrial node disease SNDis a group of abnormal heart rhythms arrhythmias presumably caused by a malfunction of the sinus node, the heart's primary pacemaker - other diabetic opthalmic compl {use addn'l code} E11.39 : COPD w/acute bronchitis/LRI {type B96-B97} J44.0 Atrial fibrillation, paroxysmal : I48.0 : RENAL/GENITOURINARY : ICD-10 - diabetic neuropathy, unspecified : E11.40 : Note: For COPD w/Emphysema use J43.9, for other COPD combinations use J44.- {Also asthma type PRN} Sick sinus syndrome I49.

Sick sinus syndrome (SSS

Sss s/p pacemaker icd 10, if a patient has a pacemaker in

ICD 10 code for Heart rhythm and Atrial Fibrillation Abnormalities of Heart Rhythm (ICD-9-CM 427.81, 427.89, 785.0, 785.1, 785.3) R00.0 Tachycardia, unspecifie Chapter 22B will provide practice coding ICD- 10-CM Chapter 19 codes. External cause codes will be discussed and coded in Chapter 23. For Chapter 22B, assign only diagnosis and procedure codes, not external cause of morbidity (V-Y) codes. 1. A child is seen emergently for an accidental overdose of vitamins ICD-10 is required for use by physicians and healthcare providers under the Health Insurance Portability & Accountability Act (HIPAA) and will replace all ICD-9 code sets. Many more new diagnoses can be tracked using ICD-10 than with ICD-9. Some expanded code sets, like ICD-10-CM, have over 70,000 codes M19.011 is a valid billable ICD-10 diagnosis code for Primary osteoarthritis, right shoulder.It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021. ↓ See below for any exclusions, inclusions or special notation Most pacemaker generators have an x-ray code that can be seen on a chest radiograph; however, the chest radiography may need to be zoomed onto the pacemaker generator for better resolution. The markings, along with the shape of the generator, may assist with deciphering the manufacturer of the generator and pacemaker battery

ICD-10 Code: Z95.0 Presence of Cardiac Pacemaker Plan: Continue with pacemaker clinic Do not use codes I49.5 sick sinus syndrome, I44.3 unspecified atrioventricular block, or R00.1 Bradycardia, unspecified, as discussed. My patient has an arrhythmia treated with pacemaker. *Coding rule now states do not code underlying rhythm unless there is. 3 Anita Schmidt, K.K., &, P.W. (2016). ICD‐10‐ CM Expert for Physicians. Optum360 4 AHA Coding Clinic, 1993, Issue 5, Sick Sinus Syndrome with previously installed pacemaker Volume 2, Issue 4, August 2015 Last Revised: April 2018 Y0114_15_25817_I_09/19/201 ICD 10 AM Edition: Eleventh Edition Query Number: 2818. A patient was admitted with principal diagnosis of SND (sinus node dysfunction) for a pacemaker insertion. Stated to have 'extensive conduction abnormalities' with 'symptomatic bradycardia/conscious collapse'. How should we code the above disorder? It is a conduction disorder but to get to.

33206 Insertion of new or replacement of permanent pacemaker with • Sinoatrial node dysfunction/Sick sinus syndrome (I49.5) • Congenital heart block (Q24.6) ICD 10 code from Group I or II with KX modifie The codes highlighted in orange indicate the individual ICD-9 code that is being mapped to one or many ICD-10 codes (Source of ICD-9-CM to ICD-10-CM mappings: CMS.org General Equivalence Mappings (GEMs), 2014) The information in this document is not intended to impart legal advice. This overview is intended as an educational tool only an support the NCD for TAVR procedures, in addition to the appropriate ICD-10 PCS code4: • Z00.6 Diagnosis Code (placed as a secondary diagnosis code): Z00.6 Encounter for examination for normal comparison and control in clinical research program to report qualified study or registry participation (e.g., REPRISE III Clinical Study, TVT Registry 2.1 Pacemaker lead perforation A 64-year-old woman presented to the emergency room with left chest pain which was aggravated with left lateral decubitus position . Four days ago, she underwent implantation of a single chamber permanent pacemaker due to sick sinus syndrome. A passive fixation lead was implanted in the right ventricle

Other ICD-10-CM code or diagnosis _____ For Adult Patients: Stable heart failure with reduced ejection fraction I50.1 Left ventricular failure I50.22 Chronic systolic (congestive) heart failure Other ICD-10-CM code or diagnosis _____ Z97.8 Presence of nasogastric tub When information in this document relates to both Micra AV and VR, Micra™ Transcatheter Pacing Systems is used to represent the portfolio of devices. 8 years = 100% VDD pacing, 60 bpm, pacing threshold 1.5 V, impedance 500 Ω, pulse width 0.24 ms. 13 years = 15% VDD pacing, 70 bpm, pacing threshold 1.5 V, impedance 600 Ω, pulse width 0. To correctly code such checks and visits, cardiologists need to understand both global surgery guidelines and the rules governing pacemaker installation and analysis. There are several implantation and replacement codes for pacemakers (3320x, 3321x), depending on whether the device is a single- or dual-chamber pacer, among other things •The Z-Codes -V-Codes in ICD-9 •Part of the classification in ICD-10 -Supplemental classification in ICD-9 •These codes are used to capture a status or problem impacting the patient that is other than a disease or external cause. •They are used in conjunction with other diagnosis codes. 5/18/2016 Jzanus Consulting, Inc. 1

The leadless pacemaker eliminates the need for a device pocket and insertion of a pacing lead which are integral elements of traditional pacing systems. The removal of these elements eliminate an important source of complications associated with traditional pacing systems while providing similar benefits Cardiovascular Genetics ICD-10 Code Reference Sheet* I49.5 Sick sinus syndrome I49.8 Other specified cardiac arrhythmias Q23.8 Brugada syndrome R00.1 Bradycardia, unspecified Z86.74 Personal history of sudden cardiac arrest Z95.0 Presence of cardiac pacemaker Z95.2 Presence of prosthetic heart valv QUESTION: A patient is admitted with pneumonia and atrial fibrillation and both are present on admission. The patient receives antibiotics for the pneumonia and a pacemaker during the stay, but undergoes no other procedures. Does the procedure automatically make ICD-9-CM code 427.31 for the atrial fibrillation the principal diagnosis

2021 ICD-10-CM Diagnosis Code Z95

With the implementation of ICD 10 came many new coding rules. One notable change comes with the coding of syncope with a pacemaker insertion. According to the new Medicare guidelines, all implanted permanent single chamber or dual chamber cardiac pacemaker claims will be DENIED if the diagnosis of R55 (syncope) appears on the claim, even if it. 3 Anita Schmidt, K.K., &, P.W. (2016). ICD-10- CM Expert for Physicians. Optum360 4 AHA Coding Clinic, 1993, Issue 5, Sick Sinus Syndrome with previously installed pacemaker Volume 2, Issue 4, August 2015 Revised: Sept. 2016 Y0114_15_25817_I_09/19/201 The pacemaker was implanted in 76 patients for symptomatic atrioventricular block and in four patients for sick-sinus syndrome. Two patients (2.5 per cent) died during the postoperative period and 19 patients within a period of 3 months to 6 years after the implantation The ICD-10-CM code Z21, Asymptomatic human immunodeficiency virus, is used when there is no documentation of symptoms, or if the patient is described as HIV positive, having known HIV, or similar terminology. Coding guidelines state that if the provider documents AIDS, or if the patient is treated for any HIV-related illness, the code B20. A biventricular pacemaker and ICD help keep the heart pumping in a more normal way. The pacemaker device keeps the heart from beating too slowly. It tries to restore the normal squeezing pattern of the heart. This is called resynchronization pacing. This can lead to more efficient and stronger heart contraction

Research Hospitalization Volume, DRGs, Quality Outcomes, Top Hospitals & Physicians for I495 - Sick sinus syndrome - ICD 10 Diagnosis Code Sick sinus syndrome may be due to de-fects in the heart itself, or it can be related to factors outside the heart. Use ICD-10 code I49.5, which includes bradycardia-tachycardia syndrome, for SSS. The diagnosis of sinoatrial node dysfunction also codes to I49.5. Category I49 excludes the following conditions: Bradycardia NOS (R00.1

Sick Sinus Syndrome By Cathie Wilde, RHIA, CCS - Director of Coding Services, Medical Record Associates, LLC Here are some common coding situations which have Coding Clinic references but for which are often missed: If a patient has a pacemaker in place for sick sinus syndrome (SSS), should the SSS (I49.5) be coded because it is being treated. The following ICD10 Codes match 'Pernicious Anemia'. Quickly lookup the latest ICD-10 CM medical diagnosis codes or browse a complete list sorted by chapter or section

Hi-Care Prov ICD-10 Coding Cardiac Arrhythmias Eng 3 2019

The type of pacemaker you need depends on the type of irregular heart rhythm you have. Some rhythms can be treated with a single-chamber pacemaker, which uses only one wire (lead) in the right atrium to pace the heart rate. However, most people with sick sinus syndrome benefit from dual-chamber pacemakers The following ICD10 Codes match 'Heart Failure (Congestive Heart Failure)'. Quickly lookup the latest ICD-10 CM medical diagnosis codes or browse a complete list sorted by chapter or section I49.5 Sick sinus syndrome (tachy-brady syndrome) R00.1 Bradycardia, unspecified V45.01 Cardiac pacemaker in situ Z95.0 Presence of cardiac pacemaker V45.02 Automatic implantable cardiac defibrillator in an ICD-9 or ICD-10 code to facilitate translating into that code's respective ICD-10 or ICD-9 code

Local Coverage Article for Billing and Coding: Single

Assign the appropriate ICD-10-CM codes for this patient's COPD and smoking history. a. J44 Other chronic obstructive pulmonary disease; Z87.891 Personal history of nicotin Research Hospitalization Volume, DRGs, Quality Outcomes, Top Hospitals & Physicians for Z45018 - Encounter for adjustment and management of other part of cardiac pacemaker - ICD 10 Diagnosis Code • 780.2 Syncope and collapse/R55 Syncope and collapse (R55 is the ICD-10 dx code but is not payable upon implementation of ICD-10 and is only included here for information purposes). Institutional claims For coverage of claims with dates of service on and after August 13, 2013, for implante

15 Diseases of the Circulatory System (ICD-10-CM Chapter 9, Codes I00-I99) Chapter Outline ICD-10-CM Official Guidelines for Coding and Reporting Anatomy and Physiology The Heart Blood Vessels Lymphatic System Disease Conditions Acute Rheumatic Fever (I00-I02) and Chronic Rheumatic Heart Disease (I05-I09) Hypertensive Diseases (I10-I15) Ischemic Heart Disease (I20-I25) Pulmonary Heart Disease. Coagulopathy due to Coumadin, other anticoagulants is now a cc, but there is a catch. What is the catch? In the 1st Q coding clinic we were given an unexpected clarification to report ICD 10 code D68 Authoritative references from which this material is drawn are the ICD- 9/ICD-10-CM Code Sets and Official Guidelines for Coding and Reporting , the CMS 2008 Risk Adjustment Data Technical Assistance for Medicare Advantage Organizations Participant Guide and the AHA Coding Clinic