Slideshare: September 2015 Q&A Medical Coding Webinar

The September 2015 Q&A Medical Coding Webinar from Certification Coaching Org (CCO), discussed a variety of topics of interest to outpatient and inpatient medical coders. Topics included Radiology Coding, Back to Basics: CPC Coding – Payment Policy, ICD-10 Code of Myocardial Infarction, Back to Basics: Practicode Case, Lesions 10,000 Series, Wound Care, and Apligraft Skin Grafts.

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 Jo-Anne Sheehan, CPC, CPC-I, CPPM; Alicia Scott, CPC, CPC-I, CRC; and Laureen Jandroep, CPC, CPC-I, COC, CMSCS, CHCI, CPPM. The host for the webinar was Boyd Staszewski.

September 2015 Q&A Medical Coding Webinar

1. Certification Coaching Q & A Webinar September 2015

2. This Month’s Q & A Webinar Agenda: 90-120 min II:  Q&A from our Instructors

  • JoAnne: Radiology Coding
  • JoAnne: Back to Basics: CPC Coding/ payment policy
  • Alicia: ICD-10 Code of myocardial infarction
  • Alicia: Back to Basics: Practicode Case
  • Alicia: Lesions 10,000 Series
  • Alicia: Wound Care
  • Laureen: Apligraf skin graft I: Introduction
  • Why stay?
  • Where is everyone from?
  • Recent CCO Graduates/ You Too?
  • Announcements and Course Updates IV: Your Questions in the Chat III: Close – @ 90 min-’ish’
  • Wrapup
  • Drawing
  • CEU Certificate Download Link Ask Along the way in the Questions box. NOTE: We can’t answer every question. If your question isn’t selected, post it on our forum where fellow coders can help:

3. 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

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


  • Tiffany Whilhem 8/15/2015 Passed CPC
  • Melanie Bleem 8/24/2015 Passed CPC
  • Sarah Lindahl 8/25/2015 Passed CPC
  • Denise Adkins 8/28/2015 Passed CPC
  • Lori Conley 8/30/2015 Passed CPC
  • Antonia Lopez 8/31/2015 Passed CPC
  • Patricia May Exconde 9/5/2015 Passed CPC
  • Gail Quinn 9/5/2015 Passed CPC
  • Pam Schulman 9/12/2015 Passed CPC
  • Barbara Michelle Bess 9/13/2015 Passed CPC
  • Alicia Espinosa 9/14/2015 Passed CPC


  • Melody Mason 8/22/2015 Passed COC
  • Cindi Duran 8/26/2015 Passed ICD-10 Assessment
  • Angela Kline 8/28/2015 Passed ICD-10 Assessment
  • Kendra Johnson 9/4/2015 Passed ICD-10 Assessment
  • Marcia Hayes 9/9/2015 Passed ICD-10 Assessment
  • Katherine Jade Martinez 9/14/2015 Passed ICD-10 Assessment
  • Elizabeth Otto 9/15/2015 Passed ICD-10 Assessment
  • Anna Burnham 9/15/2015 Passed ICD-10 Assessment
  • Anna Burnham 9/15/2015 Completed FBC Course
  • Carol Swedensky 8/23/2015 Completed MTA+PBC Course
  • Madea DeHaven 9/5/2015 Completed MTA+PBC Course
  • Sarah Lindahl 8/25/2015 Completed PBC Course

7. The CCO Bookstore!

  • The Instacode Institute
  • AMA
  • AAPC
  • Cengage
  • Elsevier CCO bookstore — now available from our CCO partners: Go to:

8. Examples of Specialty Manuals from InstaCode — Instacode Specialty Manual Subjects Behavioral Health Cardiology/Vascular Chiropractic Dentistry Dermatology Emergency Medicine ENT Otolaryngology Gastroenterology Internal Medicine Interventional Radiology Laboratory Pathology Neurology / Neurosurgery Urology / Nephrology Obstetrics / Gynecology OMS – Oral Maxillofacial Surgery Oncology / Hematology Ophthalmology / Optometry Orthopedics Pain Management Pediatrics Physical Therapy Podiatry Primary Care / Family Practice Radiology Rheumatology

9. ”CCO Swag – Pay it Forward” Program 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.

10. Don’t forget to sign up … Alicia Scott CPC, CPC-I, CRC Laureen Jandroep CPC, CPC-I, COC, CMSCS, CHCI, CPPM MODIFIERS Risk Adjustment/HCC

11. The Future of Coding >> ICD-10 Prep – CCO Style:

  • 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

12. Risk Adjustment presented by Alicia Scott, CPC, CPC-I, CCO Education Director with Content contribution by Subject Matter Expert: Holly Cassano, CPC CRC Credential – Risk Adjustment HCC Coding Course Is Here! Our HCC Course has 16 jam-packed Modules on register here: training-course

13. How to Become a Certified Medical Coder or a Medical BILLER Without The Staggering Costs of Traditional Local Schools Full educational coding and billing bundle package : $2475 (Over $5100 value) SUMMER SPECIAL winding down >>> Very limited time: MCB Bundle

14. CCO Helpdesk (You can search the knowledge base, create a ticket and check up on existing tickets)

15. Poll – What region of the country are you from? Poll

16. ● JoAnne: Back to Basics – Radiology Coding ● JoAnne: Back to Basics – Applying Coding to Payment Policy ● Alicia: Back to Basics – Practicode Case ● Alicia: ICD-10 Coding of subsequent acute myocardial infarction ● Alicia: Lesions 10,000 Series ● Alicia: Wound Care ● Laureen: Apligraf skin graft Coding Q and A Topics Alicia Scott CPC, CPC-I, CRC Jo-Anne Sheehan CPC, CPC-I, CPPM Laureen Jandroep CPC, CPC-I, COC, CMSCS,CHIC, CPPM

17. Back to Basics – Radiology Coding Question: Can you elaborate and give tips on Radiology Coding? ANSWER

18. Back to Basics – Applying Coding to Payment Policy Question: Please explain CPC coding and payment policy. ANSWER

19. Back to Basics – Practicode Case Alicia presents a Practicode case ANSWER

20. Poll What AAPC coding credential do you HAVE?

21. ICD-10 Subsequent Acute Myocardial Infarction – This example comes from AAPC Quick Reference. I want to know why we need 2 codes. Is this only a ICD-10 rule? A patient suffers an acute MI of the inferior wall 2 weeks after suffering an acute MI of the left anterior descending coronary artery. He is admitted for the new MI. I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall

21. 02 ST elevation (STEMI) myocardial infarction of left anterior descending coronary artery In this example, the second MI occurs within four weeks of the first, so it is a subsequent MI coded from category I22. The patient is admitted for the new MI, so the subsequent MI is the first‐listed code, followed by the initial MI. ANSWER

22. Poll What coding credential do you WANT?

23. Wound Care Question: Can you elaborate on wound care coding? ANSWER

24. Lesions 10,000 Series Question: I get confused when it comes to report per lesion and report number of lesions in the 10,000 series. Please help! ANSWER

25. Apligraf skin graft Question: Can you go over coding for Apligraf skin graft procedures? ANSWER

26. Want to Say Something About Us? Like the Webinar? Problems? Try different browsers

27. I can’t thank you enough for your amazing Blitz program. I took the CPC exam 2 Saturday’s ago and passed on my first try with an 87%! I only wish that I had taken your full training program as you teach exactly how I learn best. You are an awesome teacher and I will recommend your program to anyone looking for coding training. Bubble and highlight all the way! THANK YOU!!! Mary H., CPC So what are our Students saying about us? TESTIMONIALS about the CCO CPC Blitz Videos Share Your Own CCO Testimonial:


★ 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:

29. Poll Are you interested in any of our course subjects you haven’t yet taken?

30. 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! Looking to Fulfill Your CEU Requirement? More CEUs from CCO!

31. WEBINAR CEU’s – REPLAY CLUB Monthly CCO Q&A 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

32. LIKE us on Facebook — Help Us Get The Word Out


34. If you don’t already receive our newsletter, send a message to 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 ● Timely Industry Announcements ● New Course Announcements ● Remote Seminar Partners ● Congratulations to our Grads! ● Testimonials – what are people saying? ● Current Blog links Gain Access to Our Best Free Medical Coding and Reimbursement Resources! Introducing our New Weekly Newsletter Format “Heads-Up Tuesdays” Short and Sweet Links to:

35. Blitz Video Package or 2 CEU Webinars or 1 Hour Session with Laureen (or Alicia) Free Drawing! Your Choice of: Let’s Pick A Winner!

36. Questions In The Chat ANSWERS Your Webinar Chat Team

37. Chat Q & A Webinar- Sept 2015

38. Modifier 33 and Vaccine Can you shed any light on the modifier 33 and the Affordable Care Act and vaccine coding with a preventative visit?

39. Modifier 33 and Vaccine-Answer A HCPCS Code G0121 is a colorectal screening colonoscopy on individual NOT MEETING criteria for high risk-DX V76.51 Screening colon cancer. If you use 45378 which is also a colonoscopy but it is a screening with V76.51, you would add modifier 33 to indicate it was a preventive.

40. G0179 – What should I do for a patient with Medicare primary and BCBS of SC secondary and the physician office bills G0179. Medicare processes and pays, secondary is denying for invalid code?

41. G0179 – Answer G0179 is a physician re-certification for MEDICARE-COVERED home health services under a home health plan of care. There is no CPT code that matches the exact description of this Medicare code so a secondary payment is highly unlikely.

42. Unspecified Codes – I have heard if you use unspecified codes the insurance companies are going to “PIN” the claims and request for additional documentation?? Is this true?

43. Unspecified Codes -Answer Unspecified diagnosis codes are not typically queried unless a high level office visit (ex: 99215) is associated with an unspecified diagnosis not qualifying for such a high level of service. THEN you get flagged and documentation must be provided in order to get paid.

44. 1995 or 1997 Guidelines Q: Which guidelines do you suggest to use for E/M?1995 or 97? A: I find that 1997 is the most common guidelines that physicians use. More comprehensive.

45. Modifiers Change – I’m trying to get an answer on how modifiers will change since ICD10 is so much more specific now. Like we will still be using modifiers in coding after ICD10 is implemented?

46. Modifiers Change -Answer Modifiers are still required on CPT codes and must match the diagnosis code. Example, cerumen removal, bilateral 69210-50 and diagnosis code for impacted cerumen, bilateral is H61.23. The last character 3 indicates bilateral. If it ends in 0, it is unspecified, 1 is right ear, 2 is left ear.

47. Newborn 92586 – Any insight on newborn hearing cpt 92586? Certain payers are denying inclusive to facility but we own the equipment and are providing tc and pc so not being billed with a 26 modifier.

48. Newborn 92586 – Answer 92586 seems to be listed strictly as global while 92585 and 92587 use 26 and TC. 92586 seems to just present as global.
49. Different kinds of coding What is the difference between the different kinds of coding (CCA, CCS, RHIT, etc)

50. Hospital Follow-up – Can you have hosp follow-up as a chief complaint without any further details but follow-up?

51. Transition Care Management – Wouldn’t a hospital follow up be a TCM? Transition Care Management? The patient has to be contacted by a certain time as well as other guidelines pertaining to TCM?

52. Code G83.23 Code G83.23 patient is left handed, for code G83.24 Monoplegia of upper limb affecting left non-dominant side, is patient left handed or right handed?

53. Links Referenced in the Webinar:

54. Thanks For Coming! Get Value?

September 2015 Q&A Medical Coding Webinar

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