July 2015 Medical Coding Q&A Webinar

Certification Coaching Q & A Webinar- July 2015

First Webinar With Us?

Poll

How many CCO webinars have you attended?

This Month’s Q and A Webinar Agenda: 90-120 min

II: Q&A from our Instructors ● Tammy: Conversion of dx codes to DRGs ● Tammy: Auditing Question● Alicia: Fracture Coding● Alicia: ICD-10 initial encounter vs. subsequent● Alicia: Struggling with Rule of 9's● Laureen: Back to Basics - Coding Contrast● Laureen: Transbronchial Biopsy● Laureen: Coronary Arteries

I: Introduction● Why stay?● Recent CCO Graduates/ You Too?● Announcements and Course Updates

IV: Your Questions in the Chat Ask Along the way in the Questions box

If your question isn’t selected, post it on our forum where fellow coders can help:

http://www.cco.us/forum/

III: Close - @ 90 min-’ish’● Wrapup● Drawing● CEU Certificate Download

Poll

Poll - What region of the country are you from?

Why Stay To The End?

Giveaway! Free Drawing of Your Choice of 1 of the following:

Blitz Video Package | 2 CEU Webinars | 1 Hour Session with Laureen or Alicia

and...

Your AAPC CEU link for 1.5 CEUs

CCO Congratulations to Recent Graduates! Recent and You’re Not Here? >> Type in the Questions Box | Certification/Date

Patricia Rathbun 6/19/2015 Passed CPMA

Valerie Fehlman 6/19/2015 Passed CPC

Tricia Allen 6/13/2015 Passed CPC

Kate Balduff 6/1/2015 Passed CPC

Sandra Marroquin 6 / 2015 Passed CPC

Faith Wiegman 6/22/2015 Passed CPC

Jeanne Muller 6/20/2015 Passed CPC

Nancy Zizelman 6/20/2015 Passed CPC

Cheryl Cormier 6/24/2015 Passed CPC

More Congratulations to...

Shelly Thurgood 7/17/2015 Passed CPC

Melissa Barnard 6/27/2015 Passed CPC

Shannon Froning 7/11/2015 Passed CPC

Robin Thompson 6/15/2015 Passed CPC

Susan John 6/29/2015 Passed CPC

Mary Herter 6/30/2015 Passed CPC

Fereshta Porooshasp 6/20/2015 Passed CPC

Anna Vinchkoski 6/20/2015 Passed CPC

More Congratulations to... Jennifer Haduck 6/27/2015 Passed CPC +

Jennifer Haduck 7/7/2015 Passed ICD-10 Assessment

Sandra Bowers 4/18/2015 Passed ICD-10 Assessment

Jen Fowler 7/1/2015 Passed ICD-10 Assessment

Lori Holtzinger 7/5/2015 Passed ICD-10 Assessment

Everett Barker 7/8/2015 Passed ICD-10 Assessment

Charlotte McLaughlin 7/12/2015 Passed ICD-10 Assessment

Lori Conley 6/23/2015 Passed CCO PBC

Marilou Yu 6/16/2015 Got a J-O-B !!

ICD-10-CM Official Guidelines for Coding & Reporting

ATTENTION: FY 2015 - NEW CHANGES NOW POSTED

http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2015.pdf

How to read the document:● FY 2015 Narrative changes appear in bold text ● Items underlined have been moved within the guidelines since the FY 2014 ● Italics are used to indicate revisions to heading changes

● ICD-10-CM Blitz - new!○ Prepare to pass the Proficiency Assessment exam with ease!!○ 16 hour course equivalent

● ICD-10-CM Full Course **Payment Plan Now Available**○ 80 hour course equivalent○ using “Understanding ICD-10-CM” text by Bowie

● ICD-10-CM Practice Exams○ Free 25 Question Exam○ Paid 50 Question Exam - $29.95

The Future of Coding >> ICD-10 Prep - CCO Style

Remote Presentations

ATTENTION: Do you need a speaker at an upcoming

event or meeting?

Here we are >> Alicia Scott

CPC, CPC-I, CRCLaureen Jandroep

CPC, CPC-I, COC, CMSCS, CHCI, CPPM

How to Become a Certified Medical Coder or a Medical Biller

Without The Staggering Costs of Traditional Local Schools

http://go.cco.us/medical-coding-billing-course-bundle

Full MCB - educational coding and billing bundle package for:

$2475 (Over $5100 value)

SUMMER SPECIAL >>> MCB Bundle

Here's a recap of everything you'll receive when you secure your copy:

The CCO Medical Coding and Billing Training Package- MCB

Essential coursework to become a medical coder or medical biller- $1000.00

Individualized plan created just for you- $1000.00

Personal coach included- $1000.00

Weekly support calls with students and coaches- $1000.00

Practice Exams- $69.95 *

http://go.cco.us/medical-coding-billing-course-bundle

SUMMER SPECIAL >>> MCB Bundle

And You're also Getting: 6 extra months of access to all courses and coaching: 18 months total - $500.00

Replay club access for 1 year - $240.00

CCO CEU Club access for 1 year - $240.00 *

CPC Blitz for 1 year - $197.00 *

ICD-10 Blitz for 1 year - $395.00 *

6 month Payment Plan Available

* Bonus items marked are accessible upon completion of the payment plan

SUMMER SPECIAL >>> MCB Bundle

Poll

Poll - What AAPC coding credential do you HAVE?

● Tammy: Conversion of dx codes to DRGs

● Tammy: Auditing Question

● Alicia: Fracture Coding

● Alicia: ICD-10 initial encounter vs. subsequent

● Alicia: Struggling with Rule of 9's

● Laureen: Back to Basics - Coding Contrast

● Laureen: Transbronchial Biopsy

● Laureen: Coronary Arteries

Coding Q and A | July 2015

Conversion of dx Codes To DRGs

Question:

How do I convert dx codes into DRGs?

ANSWER

Auditing Question

Question: Is there any way I can get some insight on an audit situation?

Established patient came in for an earache. History documented was comprehensive. Exam was EPF. In the MDM, this was new problem to provider, with no additional work up planned, which is 3 points. The complexity and data reviewed is minimal. No lab, x-rays ordered. The risk was moderate. There was a prescription wrote for the ear. This is sort of a gray area. The presenting problem is straightforward, but the documentation supports moderate medical decision making. Should this be a 99212 or 99213, using exam and mdm as the components for choosing the level?

ANSWER

Poll

Poll - What coding credential do you WANT?

ICD-10 Initial Encounter vs. Subsequent

Question: If a patient had an injury and went to the ER for initial treatment and sutures were placed. When they come to our office for suture removal would that be an initial encounter as it is the first time at our office with this diagnosis? or would it be subsequent?

ANSWER

Poll

Are you ICD-10 Proficient?

Question: I am looking for help in fracture coding. Is there a good webinar? Suggestions?

ANSWER

Fracture Coding

The Rule of Nine’s

Question: I am struggling with the Rule of 9’s. Can you explain burn coding from and ICD and CPT perspective?

ANSWER

I saw a YouTube clip of you explaining the administration of contrast and made it look much easier with the chart. I'm unable to locate it at the web address on the slide. Is this chart still available?

I'm studying for my CPC and I'm finding the youtube clips very helpful. I'm a verbal learner and appreciate this resource.

ANSWER

Back to Basics - Coding Contrast

Transbronchial Biopsy

Question: How would you code a transbronchial biopsy of the left lower lobe of the lung with BAL washings, but with no lung tissue identified on the pathology report?

ANSWER

Coronary Arteries

Question: I am Confused with major coronary arteries questions. Can you give an example of questions with the answer as 92933-RC, 92934-LD.

One of the practice exam questions gave an example of question with an answer : 92933-RC, 92933-LD. I need more clarification on how to answer correctly the questions from major coronary arteries.

ANSWER

COURSES★ Medical Terminology & Anatomy Course (MTA)★ Physician Based Coding Course (PBC) - (CPC

course)★ Facility Based Medical Coding (FBC) - (COC

course)★ ICD-10-CM Course★ ICD-10-PCS Course★ Medical Billing Course (PBB)★ Medical Coding Auditing Course (PBMA) ★ Physician Practice Management Course (PPM)★ HCC Risk Adjustment Course★ Medical Coding Practicum (MCP) Course with Pr

acticode

Quick Lineup of CCO Courses

Reviews & Mock Exams

★ CPC Exam Review Blitz Package★ CPC Mini-Mock Practice Exams

★ ICD-10-CM Blitz Package★ ICD-10-CM Mini-Mock Practice Exams

For full listing see:

cco.us/Products

“I passed my CPC (test 6/13) on the first try.…. I know the Blitz is what really helped me to

pass. The video's were great, notes for CPT book were incredible, I am older so I got

Laureen's jokes, and of course the bubble and highlight…. On all practice tests I was able

to finish before the time and each one improved my score. When the real test came I

finished in 4 1/2 hours which left me with time to review.

Thank you all so much for the help and the great webinars. Well off to work on ICD-10

test … and then take some time off before I start on my next certification (not sure which

one yet but I know I will be coming thru CCO for it).” Tricia A. 6/19/2015

What are our Student saying?

TestimonialsTricia was sad she missed sending to our last webinar (by one day),

so we decided to highlight her!

Medical Terminology & Anatomy Course (MTA) 40 CEUs!

CEU Classes (On Demand) ranging from 1 - 4 CEUs each

ICD-10-CM Blitz Course (ICD-10 CM Proficiency Assessment) 16 CEUs!

ICD-10-CM Full Course 40 CEUs!

Facility Based Coding Course (FBC) 40 CEUs!

Physician Practice Manager (PPM) 6.5 CEUs!

Physician Based Billing Course (PBB) 18.5 CEUs!

Physician Based Medical Auditing (PBMA) 12.5 CEUs!

http://cco.us/products

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‘Snidbits’ by Alicia

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Get Access to Our Best Free Medical Coding and Reimbursement Resources!

Questions In The Chat

ANSWERS

Links Referenced in the Webinar

MCB Bundle - http://go.cco.us/medical-coding-billing-course-bundle

Administration of Contrast Chart - http://www.cco.us/administration-of-contrast

Bronchoscopic Alveolar Lavage (BAL) -

http://www.olympus-me.com/medical/en/medical_systems/applications/pulmonology/diagnostic_bronchoscopy/bronchoscopic_alveolar_lavage__bal_/bronchoscopic_alveolar_lavage__bal_.html

PCI Coding Forum Post -

http://www.cco.us/forum/threads/major-coronary-arteries.2871/

Links from Alicia’s slides

http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2015.pdf

http://www.symbiosisrcm.com/understanding-burn-codes-just-made-easy/

http://my.firefighternation.com/forum/topics/889755:Topic:

Links from Laureen’s slides

http://www.cco.us/administration-of-contrast

http://www.olympus-me.com

http://www.findacode.com/code.php?set=CPT&c=31624

http://www.cco.us/forum/threads/major-coronary-arteries.2871/

Chat Q & AWebinar- July 2015

CCs, CIC/COC?

Most of the job openings that I see are for ancillary positions. Do you think it's better to get the CCS (which is

what most of the entities ask for) or the CIC/COC?

CCS or CPC

Can you please talk a little about taking the CCS examination through AHIMA versus the CPC examination through AAPC. I have my CCA, but since finding CCO, I

am thinking I should change direction and go for the CPC. Please advise...

CPC before CPB?

I am leaning toward billing. Would it be better to take CPC first before CPB?

Guidelines ICD9/10 and CPT

What is the best way to learn the guidelines in ICD9, and CPT I know there are parathencial notes help. Any advice would be helpful.

Can you explain to me the difference between the CPT and the ICD-10 Coding?? Thank you!!

E&M Level

Is there a short cut to determining the level of care for E&M codes from a scenario that does not give the level of

hx, exam and mdm?

HMO and Medicare

If pt. has HMO plan as primary and Medicare as secondary, and the provider is not participating with HMO

plan, but is a Medicare provider, can I bill Medicare?

Burns

Alicia on the Lund Brower Diagram do you add the total numbers together to get the percentage of the burn?

If a patient is re-admitted for additional skin grafting for a non-healing burn, is the ICD-9 coded as a non-healing

wound or a burn?

ICD-10 Diabetes

Alicia, ICD-10 guidelines state that if the TYPE of diabetes is not documented then the default is Type 2

DM. Does this guideline apply to a patient that is pregnant? Or would you code UNSPECIFIED diabetes in pregnancy instead of Type 2 diabetes in pregnancy when

the type is not documented? We run into ER patients who are pregnancy with a past history of "diabetes".

Thank you!

HCPCS for BLS Emergency

What HCPCS code is reported for BLS emergency ambulance service for an automobile accident victim from the accident to the hospital, when the ambulance starts

out from the hospital? The rationale said that the Ambulance Modifiers are in the front of the Ambulance section and I simply don't see them. Help! Thank you!

Thanks For Being With Us!