The July 2015 Q&A Medical Coding Webinar from Certification Coaching Org (CCO), https://www.cco.us, discussed a variety of topics of interest to outpatient and inpatient medical coders. Topics included Conversion of Dx codes to DRGs, Auditing Question, Fracture Coding, ICD-10 Initial Encounter vs. Subsequent, Rule of 9’s, Back to Basics – Coding Contrast, Transbronchial Biopsy, and Coronary Arteries. Certification Coaching Org’s product offerings, the CCO Replay Club which allows members to review past monthly webinars and obtain CEUs, and Certification Coaching Org’s CEU offerings were also discussed. Attendees’ questions on various coding topics were answered. Educational topics were presented by Tammy Lucus, CIC, CPC, COC, CPC-I, CPMA; Alicia Scott, CPC, CPC-I, CRC; and Laureen Jandroep, CPC, CPC-H, CPC-I, CMSCS, CHCI, CPPM. The host for the webinar was Boyd Staszewski.
July 2015 Q&A Medical Coding Webinar
1. Certification Coaching Q & A Webinar- July 2015
2. First Webinar With Us? Poll How many CCO webinars have you attended?
3. 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: https://www.cco.us/forum/ III: Close – @ 90 min-’ish’ ● Wrapup ● Drawing ● CEU Certificate Download
4. Poll – What region of the country are you from?
5. 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
6. CCO Congratulations to Recent Graduates!
- 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 and;
- Cheryl Cormier 6/24/2015 Passed CPC
7. 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
8. 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 !!
9. 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
10. ● 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
11. Remote Presentations ATTENTION: Do you need a speaker at an upcoming event or meeting? Here we are >> Alicia Scott CPC, CPC-I, CRC Laureen Jandroep CPC, CPC-I, COC, CMSCS, CHCI, CPPM
12. How to Become a Certified Medical Coder or a Medical Biller Without The Staggering Costs of Traditional Local Schools https://www.cco.us/course-bundles Full MCB – educational coding and billing bundle package for: $2475 SUMMER SPECIAL >>> MCB Bundle
13. 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 * https://www.cco.us/course-bundles SUMMER SPECIAL >>> MCB Bundle
14. 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
15. Poll – What AAPC coding credential do you HAVE?
16. ● 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
17. Conversion of dx Codes To DRGs Question: How do I convert dx codes into DRGs? ANSWER
18. 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
19. Poll – What coding credential do you WANT?
20. 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
21. Poll Are you ICD-10 Proficient?
22. Question: I am looking for help in fracture coding. Is there a good webinar? Suggestions? ANSWER Fracture Coding
23. 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
24. 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
25. 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
26. 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.
27. 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 Practicode 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
28. “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? Testimonials Tricia was sad she missed sending to our last webinar (by one day), so we decided to highlight her!
29. 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 Looking to Fulfill your CEU Requirement? More CEUs from CCO!
30. WEBINAR CEU’s – REPLAY CLUB Monthly CCO Webinars: ● * Worth 1 to 1.5 CEU per meeting Replay Club: ● * up to 12 free CEUs (or more) per year ● (for indicated Webinars) – Regular Attendees – Replay Club Members https://www.cco.us/club
33. Blitz Video Package or 2 CEU Webinars or 1 Hour Session with Laureen (or Alicia) Free Drawing! Your Choice of: Pick Winner
34. ”CCO Swag – Pay it Forward” Program http://www.cafepress.com/CCOSwag CCO-BRAND SPECIALTY STORE Here is where CCO wants to partner with YOU so we can all “Pay it Forward”. The profit from all CCO Swag purchases will go into a scholarship fund for worthy students trying to afford CCO courses in their quest to enter the profession. You can purchase at the store now.
35. If you don’t already receive our newsletter, send a message to helpdesk.cco.us request to join ‘The Insider’s Club’ (Send from the email address you wish to receive your newsletter) Join the “CCO Insider’s Club” Monthly Newsletter Monthly articles by Laureen — she wants you to be ‘In the Know’ ‘Snidbits’ by Alicia ● Timely Industry Announcements ● The Course Corner ● Remote Seminar Partners ● Congratulations to our Grads! ● Testimonials – what are people saying? ● Current Blog links Get Access to Our Best Free Medical Coding and Reimbursement Resources!
36. Questions In The Chat ANSWERS
37. Links Referenced in the Webinar
- MCB Bundle – https://www.cco.us/course-bundles
- Administration of Contrast Chart – https://www.cco.us/administration-of-contrast
- Bronchoscopic Alveolar Lavage (BAL)
- PCI Coding Forum Post
38. Links from Alicia’s slides
- http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_201 5.pdf
- http://www.symbiosisrcm.com/understanding-burn-codes- just-made-easy/
39. Links from Laureen’s slides
- https://www.cco.us/forum/threads/major-coronary- arteries.2871/
40. Chat Q & A Webinar- July 2015
41. 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?
42. 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…
43. CPC before CPB? I am leaning toward billing. Would it be better to take CPC first before CPB?
44. 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!!
45. 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?
46. 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?
47. 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?
48. 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!
49. 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!
50. Thanks For Being With Us!