[CCO] Certification Coaching Organization LLC http://www.cco.us Medical Certifications - Learn It - Get Certified - Stay Certified Sat, 30 Jul 2016 10:13:32 +0000 en-US hourly 1 ICD 10 for BMI — Body Mass Index ICD-10-CM Coding http://www.cco.us/icd-10-for-bmi-body-mass-index-coding/ http://www.cco.us/icd-10-for-bmi-body-mass-index-coding/#respond Fri, 29 Jul 2016 10:09:08 +0000 http://www.cco.us/?p=27050 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Q: ICD 10 for BMI — “I was recently coding a scenario where the patient was a 20 year old obese patient and received an error with the BMI code I selected. The error indicated the code I reported was not correct for the patient age. I used the adult codes. […]

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Q: ICD 10 for BMI — “I was recently coding a scenario where the patient was a 20 year old obese patient and received an error with the BMI code I selected. The error indicated the code I reported was not correct for the patient age. I used the adult codes. Why would this be wrong? Is it an error in our EMR programming?”

A: This was a question that I find actually a number of people run in to pretty frequently in ICD-10. The reason that the person probably received this error had nothing to do with the programming and the claims scrubbing medical record, which is the question that they had.

What you actually find in ICD-10 is that for body mass index, when a patient is considered an adult is not until the age of 21. They have to be 21 or older to be considered an adult in ICD-10-CM for body mass index. That’s different than what we’ve been taught in many other areas, most of the time we think 18 is an adult. That’s true except for body mass index for these cases.

VIDEO: ICD 10 for BMI — Body Mass Index ICD-10-CM Coding

What the ICD-10 manual actually says is if the patient is between the ages of 2-20, you have to use the pediatric codes for body mass index. The difference between the adult codes and the children codes, the adult codes you select what range the patient’s body mass index is in. For the child codes, you’re selecting what percentage of a growth chart that body mass index is in. Most of us are going, “What a minute, what if our physician didn’t use our growth chart because this patient is 20 years old?” You can find one because the guidelines clearly state it’s based on the growth chart from the CDC (Centers for Disease Control).

Alicia, can you click that link for me? What I did was I included the link here in my answer sheet that will take you directly to the growth chart from the CDC’s website. There are two different growth charts, they give you one for boys and one for girls… I included the girls’ charts because I wanted to take a look at one of them when they open up, so you can see where you find this information. Down towards the bottom of the page is where you’re going to find the links for the different growth charts.

I see it says boys and girls. What we want to do is we want to pull up one of those, length for age, weight for age files so you can open the top one where it says black and white or you can open the colored one, whatever you prefer. The colored one is blue for a boy and red for a girl.

Alicia: How nice!

Chandra: They do give us body mass index in this chart…

Alicia: This is the resource that you can get the body mass index. It’s not –

Chandra: Yeah. But there is one on their site where it actually shows your body mass index. Let me send you this link because I don’t know where it’s coming from. Actually, I can just post it in the chat.

Boyd: Yeah, go for that.

ICD 10 for BMI — Body Mass Index ICD-10-CM CodingChandra: The one that I’m going to post is for the boys. What it is, is it’s the actual growth chart that includes the body mass index measurements and it may be on this page, Alicia, if you just scroll down farther, because I just search for it, I just do a Google search.

There you go: Girls BMI for age. Click on that one. This is what we want to look for. When we plot the body mass index, because oftentimes for those adult patients, the ones we think should be adults – 19, 20 year olds – the provider is going to write down what their body mass index is or their height-weight ratio and we can determine the BMI. All you have to do is look here to see where do they fall because these little pink lines, the squiggly ones, you’ll notice that top one says 95, the one below it says 90, the one below is 85, those are the percentiles where they fall in that percentile growth chart.

When you look at the body mass index codes for children, which go up to age 20, you have to know what percentage of the growth chart they fall in. In this case, if they had a body mass index of 32, they would be in the 95th, in or above the 95th percentile for height and weight for their age and gender. That’s what you have to know to select the correct codes.

I included an example here, and let’s talk through this. This is an example and this is actually another one of the questions off of the pre-employment exam that’s coming for risk adjustment. This is one that I used to get a lot when I worked in the risk adjustment hiring of coders environment. This was one that we would give to new coders to see if they understood the difference between the two.

This is a 20-year old morbidly obese patient who has a body mass index of 43.2. We do know that we have to have two codes, hopefully, if you’ve looked at the guidelines for obesity. You’ve got to code the first code for the morbid obesity, the E66.01, which does default to morbid obesity due to excess calorie intake and that’s straight from the Index and the Tabular will verify that that’s the correct code.

It then says underneath that code use additional code to identify the patient’s body mass index. Well, this is a 20-year old, they fall into the children’s codes. We don’t know their height, we don’t know their weight, we don’t even know their gender. All we know is their body mass index. We can still code this one and the reason we can still code this one, if we were to look at those growth charts again. This patient’s body mass index was 43- something. The highest level code that we have, options for BMI is 95th percentile or above. They’re there as soon as they hit 32, this patient is 43. This is just the girls’ one.

ICD 10 for BMI — Body Mass Index ICD-10-CM CodingIf you go look at the boys, you’re actually going to find it’s a little higher BMI, but 43 is still well above the 95th percentile, so we’re able to know it doesn’t matter the gender they’re going to be in that 95th percentile or higher code, which if you go back to my answer sheet is I believe it’s Z68.54. That’s why we can go ahead and use that code. We don’t have to know their gender, everything we need is right there in that answer.

I did want to point out, I’ve had a number of people ask me: “For BMI, can’t those ever go first?” No. A BMI code, that Z68 should never be your primary, your first-listed diagnosis code. Those codes are considered supplemental or informational and they’re intended to be used as additional codes to further clarify how severe the obesity or the overweight primary diagnosis code.

Just to wrap-up, when you’re looking a body mass index, remember if the patient is between the ages of 2-20 they’re considered a child and you have to use the percentile on the growth chart and have access to those CDC Growth Charts. They’re not an adult until they’re age 21, where you can actually just pick the BMI range that they fall into.

Alicia: Very exciting. It makes perfect sense why this would be on a pre-employment exam.

Related ICD 10 for BMI Posts:

ICD 10 for BMI — Body Mass Index ICD-10-CM Coding

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CCO June 2016 Q&A Webinar Intro | FREE Medical Coding Webinar http://www.cco.us/cco-june-2016-free-medical-coding-webinar/ http://www.cco.us/cco-june-2016-free-medical-coding-webinar/#respond Wed, 27 Jul 2016 10:05:50 +0000 http://www.cco.us/?p=27009 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Boyd: Welcome everybody to the Certification Coaching free medical coding webinar for June 2016. This is Boyd, your webmaster here at http://www.cco.us, along with Alicia Scott and Chandra Stephenson. Hello ladies, how are you doing today? Alicia: I’m doing great! Boyd: We’re looking forward to a great webinar once again. We do […]

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Boyd: Welcome everybody to the Certification Coaching free medical coding webinar for June 2016. This is Boyd, your webmaster here at http://www.cco.us, along with Alicia Scott and Chandra Stephenson. Hello ladies, how are you doing today?

Alicia: I’m doing great!

Boyd: We’re looking forward to a great webinar once again. We do not have Laureen Jandroep, our CEO and “Head Coding Queen” with us tonight. She’s with family, so we’re doing some pinch hitting for her, but missing her, of course. Let’s send her some greetings; if you guys want to do that, she will certainly get this after the webinar. We want to welcome you wherever you’re calling from.

VIDEO: CCO June 2016 Free Medical Coding Webinar Q&A

I want to give you a little bit of information about how this webinar works if this is your first time. Number one, this webinar is going to last about 90 minutes. There’s going to be, first of all, an introduction that we’ll go over about five minutes, then we’re going to get into the Q and A from the community, which we have prepared.

Tonight, Chandra is going to go over BMI in ICD-10-CM, HIV/AIDS and Opportunistic Infections. Alicia is going to be going over CRC Practice Exam Question, the Risk Adjustment Course Pearl for GERD, and CRC Pre-employment question. Hopefully I got that right for everybody, we haven’t got any last minute change, I think we’re good.

Then, at 90 minutes after we go through the questions here that we’ve prepared, we’re going to a wrap-up and then a drawing which I’ll tell you about in a second. Then, for those you who want 1.5 CEUs from this webinar, that’s available and we’ll tell you about that here in a second.

Number IV here says: “Your Questions in the Chat.” You have a question box probably in your GoToWebinar control panel, at any time during this evening’s presentation, you can type in a question for us and our chat team behind the scenes will copy that question and figure out, number one, if we can answer it right away, or if we will put it into the chat and answer it about 90 minutes and we’ll do that in the Q & A at the end. Our webinar usually last 2 hours, so by all means put in your questions.

We definitely welcome the first time attendees to our CCO webinars and welcome you and thank you for joining us, and we thank everyone for the time that it takes out. It was recently told to me you could buy something for $7 but your hour of your time, two hours of your time is not worth $7, so we really, really appreciate that you take the time with us, and hopefully we can give you some value back.

If you don’t get your questions answered tonight, we’ll have hundreds here so don’t be upset if we don’t get to your question right away, or if at all, because we see the questions but we just can’t get to all of them; so by all means post them but just be patient with us. But you can always go to http://www.cco.us/forum and be able to post your questions there for the whole coding community to actually give you some feedback on.

Why Stay To The End?

CCO June 2016 Q&A Webinar Intro | FREE Medical Coding Webinar

I’m going to talk to you about the giveaway that we have at the end. Alicia, tell us about the giveaway, why should people stick around to the end?

Alicia: You know CCO likes to give back, not only do we do the webinars, but we want to give you something for staying with us for this long webinar. Way back when we started this, you have a choice if you stay ‘til the end and your name is picked, we have a random drawing program, and you can get either one of our Blitz packages, you could also get an hour session with – it says Laureen or Alicia, but you could also pick Chandra, too. Or CEU packages, we have fabulous number of them; and E/M if you need some help with that or modifiers, you can pick that as well.

We hope that that is encouraging you to stay until the end, right at the 90-minute mark, Boyd, that you do that? He’s real good about keeping us on track.

Boyd: Yeah. So, stick around for that.

1.5 CEUs

CCO June 2016 Q&A Webinar Intro | FREE Medical Coding Webinar

The next slide talks about the CEU certificate. As I mentioned at the beginning, this webinar is worth 1.5 CEUs. We changed the system so some of you who might have been gone from our webinars for some time, we used to give this out for free, but because of the cost of doing our webinars and all the things that we put in for the people who joined our Replay Club, we’re nominal fee for those who want to purchase that.

This slide actually explains it a little bit better; hopefully when you come to that point in the webinar, when we’re at 90 minutes, you will understand what to do. So, basically, if you’re a current Replay Club member, you’ll see that on the left here, it says that basically you can get the CEU certificate for this webinar for free. That’s included with your membership for $19.95 a month.

But if you do need 1.5 CEUs from this webinar, you can purchase them for just $5 and that will be available with the $5 one time purchase that will look just like that; so we’ll give you that link for all of this stuff and explain it in more detail at 90 minutes, but just want to give you a heads-up about that and how that works. But this webinars are totally free otherwise.

The first poll is that we want to know a little bit about our community who is with us tonight, so we want to find out: Are you certified? Let’s launch that poll and let us know are you yes, not yet, or are you working on additional certifications?

Poll: Are you certified?

CCO June 2016 Q&A Webinar Intro | FREE Medical Coding Webinar

Chandra: Alicia and I fall into that third group.

Alicia: Yeah.

Boyd: Yeah. You never seem to stop there, Chandra, we could have a whole page on your certifications.

Chandra: Where would the fun be in stopping?

Boyd: I know, totally, right? I’m going to close it in 3, 2, 1, and I’m going to share this, guys. Yes – 65%; not yet – 26%; and 9% are working on additional certifications. Awesome!

Alicia: Good!

Chandra: Awesome!

Boyd: Thanks for sharing that.

Poll: What AAPC Coding Credential do you HAVE?

CCO June 2016 Q&A Webinar Intro | FREE Medical Coding Webinar

For those of us who have identified themselves as already having a certification. Chandra, you want to read those of as options, for those of us who are connecting maybe with telephones and things?

Chandra: Sure! The first option is the CPC/CCS-P which is about the physician-side credentials. The second are the facility credentials: COC, CIC, and the CCS. The third would be the CPMA, the auditing credential. The fourth is the CRC or the risk adjustment credential. Then, that last option is to indicate you have multiple credentials or something other than what was on the list.

Alicia: I’m so glad we got all those lumped together, so it wasn’t just one per… Look at that, how many CPMAs and CRCs we got.

Boyd: Yeah, nice. So, I’m going to close it in 3, 2… last chance. Here we go with the results of that one.

Alicia: Nice.

Boyd: CPC/CCS-P is 77%; COC/CIC/CCS is 9%; CPMA is 3%; 4% for CRC, and multiple/other is 16%. Thanks, guys.

Chandra: CRC keeps growing.

Boyd: We’re going to be talking about the CRC.

Alicia: That’s pertinent tonight.

Boyd: Yeah! Absolutely.

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Need Presentations for Your AAPC Local Chapter? CCO Presents FREE! http://www.cco.us/need-presentations-aapc-local-chapter/ http://www.cco.us/need-presentations-aapc-local-chapter/#respond Mon, 25 Jul 2016 10:05:35 +0000 http://www.cco.us/?p=26743 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Laureen: This slide is to let you know if you are involved in a AAPC local chapter or any coding group, or you would want us to come speak for you. We don’t have to live near you, we can do it remotely just like we’re doing now we can […]

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Laureen: This slide is to let you know if you are involved in a AAPC local chapter or any coding group, or you would want us to come speak for you. We don’t have to live near you, we can do it remotely just like we’re doing now we can do that for your chapter. We don’t charge, so let the chapter officers know to get in touch with us through helpdesk@cco.us.

We’ve got a pretty smooth process and we ask a lot of the groups to take a selfie of the group and send it to us. Here’s one of a chapter in Georgia that did that. This is a list of the topics that we already have pre-prepared and what’s nice is we get on, we facilitate, you talk with me, Alicia or Chandra, but if there’s a power outage you at least have a downloaded version to play for the chapter, so that’s kind of nice. If you’re interested, you can go to http://www.cco.us/remote-presentations/ or just email helpdesk@cco.us and they can send you more info.

Alicia: We’ve been doing a lot in Georgia, that’s why they’re gaining on the other guys in webinar.

Related AAPC Local Chapter – CCO Remote Presentation Posts:

Need Presentations for Your AAPC Local Chapter? CCO Presents FREE!

 

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FREE COC Practice Exam from CCO — Download NOW! http://www.cco.us/free-coc-practice-exam-download-now/ http://www.cco.us/free-coc-practice-exam-download-now/#comments Fri, 22 Jul 2016 09:46:37 +0000 http://www.cco.us/?p=26737 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

FREE COC Practice Exam – GET IT NOW! Laureen: This is where we wanted to announce that, thank you. Ruth Sheets, who is on our team, works very hard at creating our mock board exams. She‘s finished the first COC practice exam and the first one is free! So, if […]

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FREE COC Practice Exam – GET IT NOW!

Laureen: This is where we wanted to announce that, thank you. Ruth Sheets, who is on our team, works very hard at creating our mock board exams. She‘s finished the first COC practice exam and the first one is free! So, if you’re working toward that credential, check it out; that will help you see if you’re prepared for the real exam.

Where do you go?  The links down here: http://go.cco.us/free-coc-online-practice-exam and Boyd put it in the chat, I was just going to ask, great. So, check that out and see how you do.

Alicia: We have a lot of people that call in wanting to know what path to take and that’s one of the things we do is we tell them take one of the free practice exams. It’s like a test, a baseline for yourselves.

Related FREE COC Practice Exam Posts:

FREE COC Practice Exam from CCO — Download NOW!

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Percutaneous Coronary Intervention (PCI) CPT Coding http://www.cco.us/percutaneous-coronary-intervention-pci-cpt-coding/ http://www.cco.us/percutaneous-coronary-intervention-pci-cpt-coding/#respond Wed, 20 Jul 2016 09:36:23 +0000 http://www.cco.us/?p=26670 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Q: Please review PCI (Percutaneous Coronary Intervention) CPT Coding. A: These codes went through a change in 2013 and it’s a big change. You get used to how something work and you teach it year after year and it took me a while to present it in a way, and […]

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Q: Please review PCI (Percutaneous Coronary Intervention) CPT Coding.

A: These codes went through a change in 2013 and it’s a big change. You get used to how something work and you teach it year after year and it took me a while to present it in a way, and I hope I’ve gotten it tonight to help make it clear.

I want to start do some anatomy review. Basically, we’re dealing with the coronary vessels and a fix is being done to them, whether it’s a stent to bridge open the vessel or it’s a balloon angioplasty to squeeze the plaque to the side or an atherectomy to scrape it. We need to know what vessel CPT is recognizing for coding purposes.

VIDEO: Percutaneous Coronary Intervention (PCI) CPT Coding

These are the major coronary arteries that I have here on the left. We’ve got the left main. By the way, these abbreviations are also HCPCS modifiers, not all payers recognize them. Sometimes they’ll kick them back and say that it’s an erroneous modifier when it’s not, so be aware, only use them if the payer wants them; otherwise, you’re going to have to resubmit your claim. But it’s really handy for teaching to be able to just use these initials.

LM = Left Main coronary artery. LD = Left anterior descending. LC = Left Circumflex. RC = Right Coronary, and RI = Ramus Intermedius. Those are the five recognized coronary vessels by CPT. Of course there’s more but these are the ones that coding-wise are recognized.

With these PCI codes, they also recognize coronary artery branches. It’s important to know what it branches off of as I’ll show in a minute why. The first one, the left main and the last one, the Ramus Intermedius, they don’t have branches, so we don’t have to worry about them. The middle three, the LD, has two branches that are recognized they’re called diagonals. Sometimes you’ll see them abbreviated as D1, D2. The Left Circumflex has two marginals that are recognized. The Right Coronary has a posterior descending and the posterolaterals that are recognized.

Screen split, I just wanted to show you a picture of some heart anatomy. Here’s the Left Main we just talked about and here it is on the picture. Sure enough, there are no branches coming off of it, so that should help you there. The LD is right here and we can see that coming off the LD we’ve got the diagonals; even in this illustration it’s abbreviating it D1 and D2.

The LC is kind of faded in this picture in the background because it’s behind where the Left Main and LAD is, and off of it you can see the Obtuse Marginals; so they’re abbreviated OM1 and OM2. Those are two that are recognized for CPT purposes. The Right Coronary is over here and off of it you can see here are the posterior descending and the posterolaterals. These therapeutic procedures can be done in any of these main arteries or their branches. So, keep that in mind now that we have the anatomy down pat.

Percutaneous Coronary Intervention (PCI) CPT Coding - Angioplasty CodingI wanted to talk about what are some of these procedures? An angioplasty, also known as the PTCA for percutaneous transluminal – that’s through that tube – coronary angioplasty. It’s basically think of the balloon squeezing the plaque. It’s one of the least intensive of all the procedures, therefore, it tends to be bundled into everything else. The only time you would code it is if that’s all that was done to the vessel, and here’s an illustration of it. You can see the catheter with the deflated balloon being put in the middle of the vessel and there’s the plaque and then they inflate the balloon, squeezes the plaque to the side of the wall. Here’s a little cross section here.

The next higher up in intensity level of procedure is atherectomy and that’s basically somehow getting the plaque off the lining of the vessel. There are different methods that can be done. They all will use the same code, so you can have a directional atherectomy or you can have a rotational (spins and breaks it up in little pieces), or you could have a transluminal extraction (like a hook that goes down like a crochet hook and pulls it back), and then you can have laser. Those are the different kinds of atherectomy procedures.

Stents – a stent looks very similar to a balloon angioplasty but around that catheter is like a cage, a synthetic cage and it collapse and then they expand it and it helps bridge open the vessel; so now you could have that plaque squeezed to the side as well as it holding open the vessel. Very similar-looking to the PTCA, but that is higher in intensity, therefore it normally bundles in the angioplasty.

Now that we have the anatomy and now we understand the procedures, how do we code it, how would you bring it together to code it? I’ve got some coding steps here. Again, if you’re a Replay Club member, you will get access to all these answer sheets, so sit back and relax and just try and take in the information.

How to Code Percutaneous Coronary Intervention Steps:

Percutaneous Coronary Intervention (PCI) CPT Coding1. Determine all the arteries and branches that were worked on.

I recommend have a worksheet, list them out; what did you do? It might be the left main had an atherectomy, the right coronary had a stent and an atherectomy. If you can list out what was done to each vessel, each branch, that will make it much easier for you visually to be able to code it.

2. For each recognized artery or branch (this is the list here that we just looked) list all the procedures/interventions done.

Now, we want to figure out which one had the highest intensity level service done because we want to code them in order of highest level of intensity to lowest.

This chart here is taken right from the guidelines. The guidelines tell you for the base codes, this is the hierarchy order. 92943 is the most intense procedure. If you did a revascularization chronic total occlusion, that’s the highest level procedure you could do.

The next in the hierarchy is 92941, that’s also revascularization but it’s for an acute/sub-total occlusion. This one, very key, it’s during an acute MI, so this is an emergent procedure that they go in and do; there’s a heart attack going on. That’s this code. These include any of those procedures we just talked about – angioplasty, atherectomy or the stenting. You could do one, you could all 3, you don’t code them combo code is what this is.

92933 – Is the next step-down. This is when you’re doing stent(s) with an atherectomy and angioplasty if performed. Notice the stents are in plural. Sometimes they do two stents in the same vessel, you still only report one unit of 92933 because it’s stent or stents.

92924 – Going down; this is an atherectomy, there is no stent. If they also did the balloon angioplasty, the PTCA, that’s bundled in. It has to do both; if performed.

92937 – This is another revascularization. I did all the revascularizations in red. This one is of a coronary artery bypass graft. That’s key; if you’re not working, if the documentation isn’t showing that they were working on a graft, then this is not the code selection for you. It also includes any PCI.

92928 – This is a stent with angioplasty or just the stent. 92920 – Angioplasty; that’s the balloon angioplasty I showed the picture of.

These are for the base codes. You want to figure out if you had the Right Main, had one of these, had a stent; then you had to figure out was it stent with an atherectomy, or was it just the stent, or maybe with an angioplasty? That will tell you is it a 933 or 928. Did they also have a revascularization done? Well then that’s going to be 92937 unless they also had a heart attack going on; so you got to figure out all those variables and code the highest one.

On the right hand side of this picture, these are for the add-on codes. For the most part, add-on codes are used when you have an additional branch being worked on. The base codes can be used for main arteries and branches, but when it’s an additional branch, then you’re going to use this add-on code. The only exception is this first one, 92944, it’s for additional artery or branch, everything else is for an additional branch.

This is the hierarchy that they give you in CPT. For the most part, they match side by side with what we saw for the base codes. The one exception here is 92938 is considered the second highest in intensity, the revascularization, which is an add-on code to this one here. Don’t think they always go hand in hand like that.

The next one down is the 92934, that’s the stent(s) with the atherectomy. The next one down 92925 is just the atherectomy with possibly an angioplasty. Then we’re back to the stents only or with an angioplasty (92929), and finally just an angioplasty (92921). So you have this pecking order figured out, now you need to take a scenario and try and put it together.

Percutaneous Coronary Intervention (PCI) CPT CodingScenario Builder – I had made this little game that I want to try with you guys. Basically, I’ll show you real quick just so you could practice with yourself on all the different scenarios, I put in all of the vessels; so we’re going to click to spin, let’s see if we can code it. My kids were very excited when I was doing this, they came running in the room. They’re like, “What is that?” I said, “Homework” then they ran away.

This is telling me the Marginal, one of the marginals off the LC branch, let me write that down. That’s our vessel. Now, let’s figure out a procedure that’s done to that vessel. Who wants to give me a procedure? Let’s do stent with atherectomy. Let’s also do another vessel, let’s do the RC, which is the main vessel, and let’s do a revascularization and they have a sub-total occlusion.

Now we got this, using our little chart, which code is going to have the higher level of intensity? Is it going to be the stent with the atherectomy or the revascularization? We should have done a poll. Yeah, it is the revascularization, and we have two revascularization codes. We’ve got one that’s chronic total occlusion and one that’s sub-total. I said it was sub-total, so our code is going to be 92941 for that most intense procedure.

Percutaneous Coronary Intervention (PCI) CPT CodingNow, we want to code this Marginal branch that’s off of the LC. That could be done, probably not always, so how would we code that one with the stent and an atherectomy? The first question we had to figure out, should we be in the base code column, or should we be in the additional branch column? What do you say, base or add-on codes? Put in the chat. Base. Very good, Lisa.

Yes, it would be a base code because it’s not an additional branch off of the RC main; so it would get its own base code. This one stent plus atherectomy, here it is, that’s going to be the 92933. OK?

If we changed this to be the same scenario, but now we’re going to make it off the RC branch. That’s branch off the RC vessel, I meant. So, now, this is an add-on code. How would we code a stent and atherectomy, that’s an add-on code, that’s going to be this code here, 92934. So, 92941 + 92934, just an add-on code. OK? Hopefully that helped you with understanding the PCI codes better. I had fun doing it, and there’re some more examples, if you’re a Replay Club member to keep testing that out. But this chart should help a lot and I think we’re going to probably be making that available on the site as a freebie because I know this is a real tricky area.

Related Percutaneous Coronary Intervention (PCI) CPT Coding Posts:

Percutaneous Coronary Intervention (PCI) CPT Coding

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July 2016 CCO Graduates and CPC Exam Passers – Week 2 http://www.cco.us/cco-graduates-cpc-exam-passers-week-2/ http://www.cco.us/cco-graduates-cpc-exam-passers-week-2/#comments Mon, 18 Jul 2016 10:05:44 +0000 http://www.cco.us/?p=26129 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

  “Reach high, for the stars lie hidden in your soul. Dream deep, for every dream precedes the goal. ”  — Pamela Vaull Starr Huge congratulations to our new CCO graduates, CPB and CPC Exam passers!  You dreamt, you planned, you believed, you worked, and you conquered. You did it!!! The road to […]

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July 2016 CCO Graduates and CPC Exam Passers - Week 2

Reach high, for the stars lie hidden in your soul. Dream deep, for every dream precedes the goal. ” 

— Pamela Vaull Starr

Huge congratulations to our new CCO graduates, CPB and CPC Exam passers!  You dreamt, you planned, you believed, you worked, and you conquered. You did it!!! The road to your success in your career continues as you achieved a new milestone in education. Congratulations for finally finishing this degree. BIG CONGRATS to:

  • Kimberly Werth – 06/18/2016 – Completed CPC Blitz

  • Elizabeth Denmark – 06/24/2016 – Completed CPC Blitz

  • Mitzi Doss – 06/18/2016 – Completed CPC Blitz

  • Latricia Wilds – 07/07/2016 – Completed CPC Blitz, Practice Exams

  • Joan Richards – 06/26/2016 – Completed CPC Blitz, Practice Exams

  • Julie Eiselt – 07/13/2016 – Completed CPC Blitz, Practice Exams

  • Tonette Osby – 6/28/2016 – Completed Practice Exams

  • Kartika Budiarta – 06/24/2016 – Completed CPB Course (PBB)

  • Ruby Niner – 05/21/2016 – Completed CPC Course (PBC)

  • Shibu Kuriachan – 07/02/2016 – Completed CPC Course (PBC)

  • Lisa Hilliard – 06/26/2016 – Completed CPC Course (PBC), Practice Exams

  • Akila Selvaraj – 07/14/2016 – Completed CPC Course (PBC), Practice Exams

July 2016 CCO Graduates and CPC Exam Passers - Week 2

Twelve (12) of our CCO graduates are among the 2016 CPB and CPC Exam Passers.  Wow, congratulations graduates for acing your exams. We’re very proud of you. Wohooo!!!! Another great achievement unlocked! This exam may not be the biggest test of your life. But by passing with flying colors, you have proved that you are ready to take on life’s bigger tests. Congratulations. BIG THUMBS UP to: 

  • Kartika Budiarta – 06/24/2016 – Passed CPB Exam

  • Tonette Osby – 06/28/2016 – Passed CPC Exam

  • Kimberly Werth – 06/18/2016 – Passed CPC Exam

  • Ruby Niner – 05/21/2016 – Passed CPC Exam

  • Elizabeth Denmark – 06/24/2016 – Passed CPC Exam

  • Latricia Wilds – 07/04/2016 – Passed CPC Exam

  • Joan Richards – 06/25/2016 – Passed CPC Exam

  • Mitzi Doss – 06/18/2016 – Passed CPC Exam

  • Shibu Kuriachan – 07/02/2016 – Passed CPC Exam

  • Lisa Hilliard – 06/26/2016 – Passed CPC Exam

  • Julie Eiselt – 07/13/2016 – Passed CPC Exam

  • Akila Selvaraj – 07/14/2016 – Passed CPC Exam

Related July 2016 CCO Graduates and Exam Passers:

 

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How to Determine if OS Site is Primary or Secondary? http://www.cco.us/determine-os-site-primary-secondary/ http://www.cco.us/determine-os-site-primary-secondary/#comments Fri, 15 Jul 2016 13:22:20 +0000 http://www.cco.us/?p=22040 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Q: “Can we discuss coding osteoarthritis? I often see it diagnosed as osteoarthritis with a specified site but not if it is primary or secondary.” A: This one is pretty simple. A primary osteoarthritis is considered wear and tear, and is the most frequently diagnosed by healthcare providers. Secondary osteoarthritis […]

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Q: “Can we discuss coding osteoarthritis? I often see it diagnosed as osteoarthritis with a specified site but not if it is primary or secondary.”

A: This one is pretty simple. A primary osteoarthritis is considered wear and tear, and is the most frequently diagnosed by healthcare providers. Secondary osteoarthritis has a specific cause, such as an injury or resulting from obesity, genetics, inactivity or other diseases. Then, there’s also post-traumatic osteoarthritis, which is the wearing out of a joint that has had any kind of physical injury.

What exactly is osteoarthritis? It’s the breakdown of cartilage causing the bones to react to those areas, often developing bone spurs or growths. The joints may become inflamed and swollen. When the bones touch without the protective cartilage, pain and stiffness result. When we’re coding for osteoarthritis, we have a site and laterality designations.

VIDEO: How to Determine if OS Site is Primary or Secondary

I find that doctors such as orthopedics, podiatrist, chiropractors, they tend to be much more specific with laterality and the site; however, primary care has a tendency to just write osteoarthritis.

Primary osteoarthritis typically develops around 55-60 and it is associated with aging. The longer you use your joints, the more likely you are to get this type of arthritis.

Secondary osteoarthritis is either from an injury, if you fracture a bone playing sports or are in a motor vehicle accident, you will most likely develop osteoarthritis in that joint. Obesity – the extra weight bears down on the joints every day causing the joint to wear away faster. Inactivity – if you are inactive, you have weaker muscles and tendons that surround the joint. Strong muscles keep the joints properly aligned.

Genetics – you may carry genes that put you at risk. Then, inflammation from other diseases – rheumatoid arthritis can increase your risk of getting osteoarthritis later in life.

How to Determine if OS Site is Primary or Secondary?The next page is a picture of osteoarthritis of the hip. You can actually look at the two and you can see the difference between the normal side of the hip and the one with the osteoarthritis. The code range for osteoarthritis is M15 to M19. I just happened to pick the M16 – osteoarthritis of the hip, and the laterality is identified within the category. This is not even all of them, I just picked these particular codes just to show you how they’re labeled.

M16.0 will be bilateral primary osteoarthritis of the hip, and then .10 is the unilateral primary, unspecified hip; .11 is primary unilateral, right hip; .12 is unilateral primary, left hip; .4 is unilateral post-traumatic, unspecified hip; and .7 is secondary arthritis of hip, other unilateral. There are a lot more in the M16 as well as the other codes, but I just wanted to point out those key words: primary, post-traumatic, and secondary.

Now, what you need to look for and one of the things you learn with ICD-10 is that you’re not only learning the coding, but you’re also learning the pathophysiology. First, when you’re looking at the documentation, before you query the physician, wanted to see if it’s in the documentation, is the hip, the knee, the carpometacarpal joint? Does it indicate in the documentation, even if the doctor just chose osteoarthritis, if it’s left, right or bilateral?

If the physician does not provide information regarding being primary, secondary, or
post-traumatic, you may reference that in the note. He may indicate age, or wear and tear. He may indicate that the patient is obese and gives a body mass index and so forth. You may be able to determine from the documentation if it’s a primary or secondary. Does the note indicate stiffness or joint enlargement? Is there lab work indicating a white blood count or x-rays taken? Things like that.

If you cannot figure it out based on this type of information, then you have to query the physician. I can tell you firsthand that these unspecified codes are not going well with the insurance companies so you really want to be specific.

How_to_Determine_if_OS_Site_is_Primary_or_Secondary_-_YouTube-2In the last slide it will show the synovial joint, and again, it just shows you what a healthy joint looks like and then when you look at the osteoarthritis illustration, you can look at where the cartilage is not there and the whole joint cavity with synovial fluid is just very thin, so the bones rubbing together and that’s basically what it is.

So, the primary is wear and tear, secondary is due to a lot of other factors. If you can’t determine based on documentation, I would query the doctor unless you want to use unspecified. They’re there, but as a biller, I don’t recommend it. It’s a pain to have to appeal a claim and they’re not liking the unspecified diagnosis codes in most cases.

Laureen: That was one of the questions in the chat. If they just say osteoarthritis, do you code it as unspecified? Your advice is to query the physician, but if you can’t do that then you have to go with unspecified, right?

JoAnne: Right. Again, it really depends on the insurance company, but I can tell you 8 out of 10 times any unspecified codes that the billers that I know used end up having to appeal the claim, that insurances don’t like it, particularly when it comes to the bones. Just saying. That’s pretty much it.

Laureen: Thanks JoAnne.

JoAnne: You’re welcome.

Related How to Determine if OS Site is Primary or Secondary Posts:

How to Determine if OS Site is Primary or Secondary

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Emergency Department Visits Diagnoses Medical Coding Guidelines http://www.cco.us/emergency-department-visits-diagnoses-medical-coding-guidelines/ http://www.cco.us/emergency-department-visits-diagnoses-medical-coding-guidelines/#respond Wed, 13 Jul 2016 09:44:02 +0000 http://www.cco.us/?p=21961 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Q: Are Emergency Department visits diagnoses which state “suspected,” “presumed,” etc., to be coded following the inpatient or outpatient guidelines? That is, are coders to follow inpatient guidelines of “confirmed” if the patient is admitted through the ED to Observation/Inpatient status and use the outpatient guidelines of “not confirmed” if […]

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Q: Are Emergency Department visits diagnoses which state “suspected,” “presumed,” etc., to be coded following the inpatient or outpatient guidelines? That is, are coders to follow inpatient guidelines of “confirmed” if the patient is admitted through the ED to Observation/Inpatient status and use the outpatient guidelines of “not confirmed” if the patient is discharged from ED to home? Can you please give me directions on this?

A: That is a great question. When we take a look at this, a couple of things to remember, the question confused a few things: you got to remember what areas of the hospital are considered outpatient hospital departments. Both the Emergency room and Observation status, even if the patient is “admitted” to observation, that is still considered an outpatient part of the hospital. Those outpatient departments are required to follow the Section IV guidelines in the ICD-10 manual. Those are the guidelines for Diagnostic Coding and Report Guidelines for Outpatient Service.

According to that, most facilities – just to give you an idea of what happens in most facilities – if a patient presents to the emergency room, those emergency room charges are entered into the system. And guess what, they actually get put into the same system, if you will, as the charges that are used to generate your inpatient claim. If we have a patient come into the ER whether they’re discharged and sent home or admitted to the inpatient facility, they get put in to the hospital billing system, and so do the inpatient charges that the patient is admitted.

VIDEO: Emergency Department Visits Diagnoses Medical Coding Guidelines

When the claim is generated, they then look to see what place of service did that patient wind up in to determine which rules do we need to follow. If they wind up in the inpatient environment, they were admitted for a full hospitalization, the claim that’s generated is going to utilize the inpatient diagnosis, quite frankly. It is going to code for all of the different pieces that it needs to.

As an ER coder or an ED coder, what you need to do is remember that regardless of where the patient winds up, your services is part of the hospital outpatient department and you have to code those accordingly, so you’re going to follow those Section IV guidelines.

When it comes to uncertain diagnoses, which is what this question started with: What do I do with those probable, suspected, likely, rule out, all of those? The guidelines are specific. What I did was I pasted in a picture of the guidelines directly from my coding manual, that’s why they’re all marked up and then I typed up the same thing. In case it came out blurry or you had trouble reading it, you can actually see it typed as well.

Emergency Department Visits Diagnoses Medical Coding GuidelinesWhat those guidelines say is if you’re coding for the hospital outpatient department, you do not code for any diagnoses that is documented as “probable,” “suspected,” “questionable,” “rule out,” or “working diagnosis” or anything else that indicate uncertainty; so no “probable,” “likely,” “suspected,” anything like that.

Instead, what you do is you code what the highest degree of certainty was that the provider knew during that ER visit, what did they know? Maybe they only knew the patient had abdominal pain, that’s all you could code. They haven’t figured out yet what else was going on with the patient, so you’re going to code whatever it is you know. That can be signs and symptoms, that can be abnormal test results, it could be any other reason for the visit if you don’t have a definitive diagnosis. That’s if you’re coding for the hospital outpatient department like the emergency room.

What do you do if you’re the inpatient coder? We ask this question from an ER perspective, but what happens if I’m an inpatient coder and I’m coding for the facility charges inside the hospital? Quick designation I want to make, a lot of people confused inpatient and outpatient and they think, “Oh, outpatient is the doctor, inpatient is the hospital.” No. We’re talking about different places of service.

The physician services, those are what we call our professional services, our pro fees, and that doctor can provide services on either place. They can work in their office or they can work in the hospital. Either way, they are considered an outpatient entity, they have to follow the outpatient rules because we’re not billing, they’re not billing for the hospital.

The hospital has two different sets of rules, either we have the outpatient departments like we just talked about with the ER, or we’re billing for the inpatient services, the full admission where we’re billing for room and board and lights and all of the equipment that we use and everything else. Well, if you’re an inpatient coder billing for the facility, your roles are different. Instead of Section IV, which is what the outpatient and the physician’s follow, in the inpatient hospital environment you follow the Section II guidelines, and those tell you what to do.

They say specifically under Section II.H, it says Uncertain Diagnosis. If you’re coding for the inpatient hospital facility, you are going to take what the diagnosis says at the time of discharge. Not at the time they’re admitted, but right when we send them home, that discharge summary.

Emergency Department Visits Diagnoses Medical Coding GuidelinesWhat did we know? If it was “probable,” “suspected,” “likely,” “questionable,” “possible,” any uncertain term, you get to code it as though it existed. You code it just like it was an established condition. If it says “possible appendicitis” you code it as appendicitis.

The reason for this is, when we’re billing in the inpatient facility environment, we are billing for the services that it took to rule in or rule out that diagnosis. It doesn’t matter whether the patient has appendicitis or not. If we’re trying to figure out whether they have it, we’re going to use the same amount of resources to rule it in as we would to rule it out. That’s the only reason this differ.

The other reason that they differ, if I’m billing for the facility, I can assign a diagnosis that says “rule out appendicitis,” I can call it appendicitis and it never attaches to my patient. It simply says we used all of the services that we needed to rule out appendicitis. If I attach it from an outpatient or a physician perspective, that diagnosis attaches to the patient because we’ve said it’s a confirmed diagnosis, that’s what the guideline says. If I were to assign something that the patient did not actually have, I was still trying to figure out, rule it out, I could wind up putting something they never had on their record and it’s very, very difficult to then get that removed and that creates all sorts of problems for the patient down the road. Worst case scenario, we accidentally assign a cancer diagnosis or heart attack diagnosis to a patient who never had either. That could prevent them from getting life insurance, all sorts of issues.

That’s why you need to remember when you’re coding for these, if I’m coding for the inpatient facility, I follow the Section II rule that says: “Hey! I can code those ‘probable,’ ‘suspected,’ ‘likely,’ ‘rule out.’” If I’m coding for the outpatient hospital or I’m coding for the physician, oh no those attached to the patient and I follow the Section IV guidelines that say I cannot use those. If you’re an ED coder or an ER coder, your hospital outpatient facility and you got to remember when you got a probable, a suspected, a likely or any kind of uncertain diagnosis, we cannot code for those. I think that wraps that one up.

Laureen: I just wanted to say, too, for people that are seeing Chandra’s notes, many people are familiar with CCO’s bubbling and highlighting technique, this is Chandra’s version of annotation; and so, the same way that we make available my entire CPT manual, to see all of the notes, we’re doing the same with Chandra’s ICD-10 manual. That’s very valuable, so if you’re a full student of ours, you get access to that. I just wanted to throw that in there and her handwriting is a lot neater than mine.

Related Emergency Department Visits Diagnoses Posts:

Emergency Department Visits Diagnoses Medical Coding Guidelines

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Correct Coding Sequence of Vaccine Administration Codes http://www.cco.us/correct-coding-sequence-vaccine-administration-codes/ http://www.cco.us/correct-coding-sequence-vaccine-administration-codes/#respond Mon, 11 Jul 2016 09:20:22 +0000 http://www.cco.us/?p=21943 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

Q: What should be the correct coding sequence about the vaccine? Do we code the vaccine first and then the administration code? Do we code the administration code first and then the vaccine? What is the correct sequence code? A: For vaccine administration, what you’re going to find is there […]

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Q: What should be the correct coding sequence about the vaccine? Do we code the vaccine first and then the administration code? Do we code the administration code first and then the vaccine? What is the correct sequence code?

A: For vaccine administration, what you’re going to find is there is no one set rule that says they have to go in this order. Now, most of the time when we think about multiple procedures and yes, a vaccination is considered a procedure, when we think about multiple procedures most of the carrier rules, most of the suggestion you’re going to find is, list them in RVU order, so you list the most expensive one to the least expensive one.

Here is the funny thing, the toxoid or the product, the actual vaccine that were injected, whether it’s Tdap or DTaP or a HeB or an influenza vaccine, anything like that, there’s no actual work RVU associated with those. The doctors don’t create those in their office, they purchase the product, so there’s no work RVU associated with it. If you will look it up and try to find the RVU oftentimes you get a big fat zero. The funny thing is, that’s usually the most expensive part of administering the vaccine, so most people would list the most expensive piece first, the different toxoids that they do, and then they list the administration fee.

VIDEO: Correct Coding Sequence of Vaccine Administration Codes

Before they do any of those, they list any E/M procedures that may have been performed. If we did a well-child visit and it was a preventive visit for that child, we would bill the E/M visit for the preventive visit, then we would bill our products, what vaccines did we give along with our administration codes? Remember when you get to the administration codes, you can only report one initial administration code per encounter. So, the very first vaccine they got, it doesn’t matter what route it was, you only get to bill one initial. The reason I say that, a lot of little kids we give them the nasal flu vaccine; that’s an intranasal administration. We might also give them another vaccine while they’re there and we might do that intramuscularly.

Those two codes when you look at the administrations, both have an initial code. They cannot have two initial administrations in the same visit, only one of them was truly given first. It doesn’t matter which one you gave first, if you gave the nasal first, you bill initial intranasal and then you bill an add-on for the intramuscular. If you gave the intramuscular first, you bill the initial intramuscular and the nasal as an add-on. You just don’t want to put two of those initials up against each other or they’ll bump out in your claim editing software.

I did want to remind you that not just with vaccines, but with any of your procedure codes. If you’re worried about sequencing, you’re trying to figure out the best order to put them in, you can always use that Physician Fee Schedule Lookup Tool – we went through that a few webinars ago. If you’re not familiar with it, I also go through it on the “Free CMS Did You Know” episode, that’s on our Facebook Live page. But I show you how to go look something up on the fee schedule. You can go to the CMS Fee Schedule and if it’s a procedure that CMS covers and that they price, they will give you the RVU associated with it so you can figure out which one is more expensive and what order they should go in. That’s a great tool to go out and use when you’re trying to answer the sequencing of procedure questions.

To recap and answer the question, when asked: What order do these vaccines need to go in? Do we list the product first or the administration first? There is no one set rule. You can list them in either order. Most people list the toxoid or the product first because it’s more expensive, then they list the administration code.

Laureen: Thank you.

Related Correct Coding Sequence of Vaccine Administration Codes Posts:

Correct Coding Sequence of Vaccine Administration Codes

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Slideshare: June 2016 Q&A Medical Coding Webinar http://www.cco.us/slideshare-june-2016-qa-medical-coding-webinar/ http://www.cco.us/slideshare-june-2016-qa-medical-coding-webinar/#respond Fri, 08 Jul 2016 10:05:46 +0000 http://www.cco.us/?p=21927 Visit [CCO] Certification Coaching Organization LLC for more articles about [CCO] Certification Coaching Organization LLC - Medical Certifications - Learn It - Get Certified - Stay Certified.

The June 2016 Q&A Medical Coding Webinar from Certification Coaching Org (CCO), discussed a variety of topics of interest to medical coders. Topics covered included BMI in ICD-10-CM, HIV / AIDS and Opportunistic Infections, a CRC Practice Exam Question, RA Course Pearl – GERD, and a CRC Pre-Employment Question. The […]

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The June 2016 Q&A Medical Coding Webinar from Certification Coaching Org (CCO), discussed a variety of topics of interest to medical coders. Topics covered included BMI in ICD-10-CM, HIV / AIDS and Opportunistic Infections, a CRC Practice Exam Question, RA Course Pearl – GERD, and a CRC Pre-Employment Question. The CCO VIP opportunity and CCO’s Lunch & Learn Coding on FB Live, were also discussed. Attendees’ questions on various coding topics were answered. Educational topics were presented by Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC and Alicia Scott, CPC, CPC-I, CRC. The host for the webinar was Boyd Staszewski.

VIDEO: June 2016 Q&A Medical Coding Webinar from Laureen Jandroep

1. Certification Coaching Q&A Medical Coding Webinar June 2016

2. June 2016 | Q&A Medical Coding Webinar Agenda: 90-120 min II: Q&A from the CCO Community I: Introduction

  • CCO News and Updates
    • Chandra Stephenson:
      • *BMI in ICD-10-CM
      • *HIV/AIDS and Opportunistic Infections
    • Alicia Scott
      • *CRC Practice Exam Question
      • *RA Course Pearl – GERD
      • *CRC Pre-employment question

3. This Month’s Q&A Medical Coding Webinar Agenda: 90-120 min IV: Your Questions in the Chat III: Close – @ 90 min-’ish’

  • Wrapup
  • Drawing
  • CEU Certificate Download Link
    • If your question isn’t selected, post it on our forum where fellow coders can help: http://www.cco.us/forum/
    • Ask Along the way in the Questions box. NOTE: We can’t answer every question.

4. Why Stay To The End? Giveaway! Free Drawing of Your Choice on 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 (a change tonight)

5. 1.5 CEU’s | CCO Monthly Q&A Medical Coding Webinar – Don’t need CEU’s? Continue to attend the CCO webinar for free! *CEU Link at the end of the webinar (+/- 90 min)

6. Poll Poll Poll – Are You Certified?

7. Poll What AAPC coding credential do you HAVE?

8. CCO Graduates June Update

9. CONGRATS! CCO Courses

  • Christy Williams 05/27/2016 Completed CPC Blitz
  • Alena Metallides 05/21/2016 Completed CPC Blitz
  • Lisa Gordon 04/21/2016 Completed CPC
  • Blitz Pamela Herbert 05/21/2016 Completed CPC Blitz
  • Peggy Moser 04/24/2016 Completed CPC Blitz
  • Denise Hess 05/27/2016 Completed CPC Blitz
  • Valerie Godby 05/31/2016 Completed CPC Blitz
  • Lisa Benson 05/21/2016 Completed CPC Blitz
  • Deborah Imig 02/16/2016 Completed CPC Blitz

10. CONGRATS! CCO Courses

  • Sheree LaShelle 06/04/2016 Completed CPC Blitz
  • Jeanie Strom-Raffauf 06/04/2016 Completed CPC Blitz
  • Michelle Taylor 05/21/2016 Completed CPC Blitz
  • Karen Barroso 06/11/2016 Completed CPC Blitz
  • Genalyn Wichern 06/10/2016 Completed CPC Blitz
  • Diane Mason 06/11/2016 Completed CPC Blitz
  • Robyn Reynon 05/26/2016 Completed CPC Blitz
  • Erin Al-Hammami 04/16/2016 Completed CPC Blitz
  • Lisa Price 05/28/2016 Completed CPC Blitz

11. CONGRATS! CCO Courses

  • Lisa Auerbach 05/28/2016 Completed CPC Blitz
  • Tekeya M. 05/28/2016 Completed CPC Blitz
  • Andrea Marshall 06/07/2016 Completed CPC Blitz
  • Tara 06/11/2016 Completed CPC Blitz
  • Summer Rentschler 06/04/2016 Completed CPC Blitz
  • Kayla Sanchez 06/11/2016 Completed CPC Blitz
  • Lisa Dietrich-Blocker 06/16/2016 Completed CPC Course (PBC)
  • Ann Renee Holl 06/17/2016 Completed CPC Course (PBC)
  • Kathleen Zaccardi 05/28/2016 Completed CPC Blitz, Practice Exams

12. CONGRATS! CCO Courses

  • Frances Woodard 06/04/2016 Completed CPC Course (PBC), Completed CPC Blitz, Practice Exams
  • Kimberly Morris 05/07/2016 Completed CPC Blitz, CPC Course (PBC), Practice Exams
  • Brenda L Coreano Burgos 06/04/2016 Completed CPC Blitz, Practice Exams
  • Christina Miller 05/21/2016 Completed CPC Blitz, Practice Exams
  • Sylvia Hatley 04/30/2016 Completed CPC Blitz, Practice Exams
  • Judy Riggs 05/28/2016 Completed Practice Exams
  • Angela Wilson 04/16/2016 Completed Practice Exams
  • Marie Barilla 05/28/2016 Completed Practice Exams

13. CONGRATS! CCO Courses

  • Elizabeth Castellanos 06/03/2016 Completed MTA Course
  • Tameka Duncan 06/16/2016 Completed MTA Course
  • Denise Adkins 01/27/2016 Completed ICD-10 Blitz Videos
  • Deborah A Harden 06/21/2016 Completed CIC Blitz

14. CONGRATS! Passed CPC Exam

  • Faye Ocenar 05/11/2016 Passed CPC Exam
  • Cyndi Owen 05/17/2016 Passed CPC Exam
  • Glenda Correa 04/09/2016 Passed CPC Exam
  • Loveta Walls 05/21/2016 Passed CPC Exam
  • Mary Berger 05/14/2016 Passed CPC Exam
  • Deanna Lambert 05/23/2016 Passed CPC Exam
  • Susan Woods 05/20/2016 Passed CPC Exam
  • Ana Vasquez 05/21/2016 Passed CPC Exam
  • Melanie Diehl 05/27/2016 Passed CPC Exam

15. CONGRATS! Passed CPC Exam

  • Sylvia Hatley 05/11/2016 Passed CPC Exam
  • Christy Williams 05/27/2016 Passed CPC Exam
  • Alena Metallides 05/21/2016 Passed CPC Exam
  • Lisa Gordon 04/23/2016 Passed CPC Exam
  • Pamela Herbert 05/21/2016 Passed CPC Exam
  • Peggy Moser 04/24/2016 Passed CPC Exam
  • Denise Hess 05/27/2016 Passed CPC Exam
  • Laura Zmolek 05/21/2016 Passed CPC Exam
  • Valerie Godby 05/31/2016 Passed CPC Exam

16. CONGRATS! Passed CPC Exam

  • Judy Riggs 05/28/2016 Passed CPC Exam
  • Lisa Benson 05/21/2016 Passed CPC Exam
  • Deborah Imig 02/16/2016 Passed CPC Exam
  • Brenda L Coreano Burgos 06/04/2016 Passed CPC Exam
  • Lisa Auerbach 05/28/2016 Passed CPC Exam
  • Tekeya M. 05/28/2016 Passed CPC Exam
  • Christina Miller 05/21/2016 Passed CPC Exam
  • Janet Michaud 06/07/2016 Passed CPC Exam
  • Andrea Marshall 06/07/2016 Passed CPC Exam

17. CONGRATS! Passed CPC Exam

  • Kimberly Morris 05/07/2016 Passed CPC Exam
  • Robyn Reynon 05/26/2016 Passed CPC Exam
  • Angela Wilson 04/16/2016 Passed CPC Exam
  • Erin Al-Hammami 04/16/2016 Passed CPC Exam
  • Lisa Price 05/28/2016 Passed CPC Exam
  • Kathleen M. Zaccardi 05/28/2016 Passed CPC Exam
  • Sheree LaShelle 06/04/2016 Passed CPC Exam
  • Frances Woodard 06/11/2016 Passed CPC Exam
  • Celeste Currier 06/04/2016 Passed CPC Exam

18. CONGRATS! Passed CPC Exam

  • Michelle Taylor 05/21/2016 Passed CPC Exam
  • Lisa Dietrich-Blocker 06/16/2016 Passed CPC Exam
  • Karen Barroso 06/11/2016 Passed CPC Exam
  • Genalyn Wichern 06/10/2016 Passed CPC Exam
  • Diane Mason 06/11/2016 Passed CPC Exam Ann
  • Renee Holl 06/17/2016 Passed CPC Exam
  • Tara 06/11/2016 Passed CPC Exam
  • Summer Rentschler 06/04/2016 Passed CPC Exam
  • Cassandra Reynolds 06/11/2016 Passed CPC Exam
  • Kayla Sanchez 06/11/2016 Passed CPC Exam

19. CONGRATS! Passed CPC Exam

  • Jeanie Strom-Raffauf 06/04/2016 Passed CPC Exam
  • Marie Barilla 05/28/2016 Passed CPC Exam
  • Marilyn Rosario 06/11/2016 Passed CPC Exam
  • Deborah A Harden 06/21/2016 Passed CIC Exam

20. Testimonials and Reviews https://www.facebook.com/cco.us/reviews

21. Testimonials and Reviews http://www.cco.us/testimonials/

22. What coding credential do you WANT? Poll

23. Q&A From the Community

  • Alicia Scott, CPC, CPC-I, CRC CCO Education Director
  • Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COaaSC, CRC, CCC CCO Program Director

24. BMI in ICD-10-CM Question: I was recently coding a scenario where the patient was a 20 year old obese patient and received an error with the BMI code I selected. The error indicated the code I reported was not correct for the patient age. I used the adult codes. Why would this be wrong? Is it an error in our EMR programming? Answer Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPPM, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC CCO Program Director

25. First Webinar With Us? Poll How many CCO webinars have you attended?

26. HIV/AIDS and Opportunistic Infections Question: What is the difference between AIDS and HIV? How do I know when to use the AIDS code (B20) instead of the HIV code (Z21)? What role, if any, do “Opportunistic Infections” play? Answer Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPPM, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC CCO Program Director

27. https://www.facebook.com/cco.us/ Wednesday 2PM EasternLunch and Learn Coding

28. Poll What’s your best time to attend a free live medical coding training?

29. Free Practice Exams Now Available http://www.cco.us/free-tools-reports-and-exams-for-medical-coding-and-billing/

30. CRC Practice Exam Question Question: What does a CRC Exam Question look like? How do we work through an exam question? ANSWER Alicia Scott, CPC, CPC-I, CRC CCO Education Director

31. Risk Adjustment 2.0 Early Bird A Complete “No-Fluff” Course That Will Teach You The Core Essentials of Risk Adjustment AND Prepare You For The CRC™ Exam http://www.cco.us/certified-risk-adjustment-coder-crc-course-exam-preparation

32. Risk Adjustment 2.0 Early Bird http://www.cco.us/certified-risk-adjustment-coder-crc-course-exam-preparation

33. Risk Adjustment 2.0 Course Contents http://www.cco.us/certified-risk-adjustment-coder-crc-course-exam-preparation

34. Risk Adjustment 2.0 Course Contents Early Bird (Save $100) Ends Thursday June 30th 2016 http://www.cco.us/certified-risk-adjustment-coder-crc-course-exam-preparation FAQ

35. RA Course Pearl – GERD Question: Our Risk Adjustment course has “Pearls of Wisdom” on 20+ diseases that risk adjust and carry and HCC. These tools were created to assist you in the increase of your knowledge base when doing diagnosis coding. ANSWER Alicia Scott, CPC, CPC-I, CRC CCO Education Director

36. It’s FREE! FREE! Join Now! Limited Seats Available! Details & Register Now: http://www.cco.us/webinarvip

37. CCO Presents Free! Topics include: Need Presentations for Your Local AAPC Chapter? More Information: http://www.cco.us/remote-presentations/

  • The Local AAPC Chapter of Columbus GA for “EM Coding: Locate Your HEM in Time”
  • EM: “Locate your HEM in Time – A Unique Way to Understanding EM Coding”
  • What is HCC/Risk Adjustment Coding
  • How to prepare for CPC Exam Modifiers – It’s All About The Money
  • How to “Prepare for ICD-10 Proficiency without Stress”
  • CPT Coding updates
  • Any section of the CPT Manual – Anesthesia, Integumentary, Digestive, Medicine
  • Any section of ICD manual or guidelines
  • Any topic you’d like developed!
  • “Cardiology Section of CPT” Jackson MS

38. New Blitz Reviews Ready for You

  • ➢ CPC Review
  • ➢ ICD-10-CM
  • ➢ ICD-10-PCS
  • ➢ COC – Outpatient
  • ➢ CIC – Inpatient
  • ➢ RA – Risk Adjustment
  • ➢ 2016 CPT Updates

39. CRC Pre-employment Question Question: What is a good example of a CRC pre-employment question? What are employers looking for? ANSWER Alicia Scott, CPC, CPC-I, CRC CCO Education Director

40. Your Questions from the Chat Questions In The Chat- June 2016 Your Webinar Chat Team

41. Contusion and Abrasion Question: Is the code rule for contusion and abrasion the same as ICD9 was, ei code contusion only or do we code both now?

42. Billing Sick with Well Visit Question: When billing a sick with well visit, what constitutes a sick visit (above and beyond what is done during a well visit)? this is a huge issue in our practices

43. E/M with Diabetes Question: When coding say an E/M encounter and the patient has type 2 diabetes documented in the medical record but the patient is not seeing the provider for her diabetes, is it still listed as a diagnosis?

44. BMI Question: What about women who have lack of thyroid and metabolism is not working as in I? Hard to impossible for weight control. BMI Can ICD-10 code to the cause of BMI?

45. Cast & X-ray Application Question: When coding for application of a cast, cast supplies, & x-ray,during post op would we append the 58-mod to the application of the cast?

46. SNF & LTC Coding Question: Can you ever do anything with SNF & LTC coding? Very little help out there.

47. LIKE us on Facebook http://facebook.com/cco.us Help Us Get The Word Out

48. Links Referenced in the Webinar:

49. Thanks For Coming! Got Value? http://www.cco.us/webinarvip

50. Happy Coding!

  • The Local AAPC Chapter of Columbus GA
  • The Local AAPC Chapter of Savana GA

Slideshare: CCO June 2016 Free Q&A Medical Coding Webinar

 

The post Slideshare: June 2016 Q&A Medical Coding Webinar appeared first on [CCO] Certification Coaching Organization LLC.

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