July 2015 Medical Coding Q&A Webinar
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Transcript of July 2015 Medical Coding Q&A Webinar
This Month’s Q and A Webinar Agenda: 90-120 min
II: Q&A from our Instructors ● Tammy: Conversion of dx codes to DRGs ● Tammy: Auditing Question● Alicia: Fracture Coding● Alicia: ICD-10 initial encounter vs. subsequent● Alicia: Struggling with Rule of 9's● Laureen: Back to Basics - Coding Contrast● Laureen: Transbronchial Biopsy● Laureen: Coronary Arteries
I: Introduction● Why stay?● Recent CCO Graduates/ You Too?● Announcements and Course Updates
IV: Your Questions in the Chat Ask Along the way in the Questions box
If your question isn’t selected, post it on our forum where fellow coders can help:
http://www.cco.us/forum/
III: Close - @ 90 min-’ish’● Wrapup● Drawing● CEU Certificate Download
Why Stay To The End?
Giveaway! Free Drawing of Your Choice of 1 of the following:
Blitz Video Package | 2 CEU Webinars | 1 Hour Session with Laureen or Alicia
and...
Your AAPC CEU link for 1.5 CEUs
CCO Congratulations to Recent Graduates! Recent and You’re Not Here? >> Type in the Questions Box | Certification/Date
Patricia Rathbun 6/19/2015 Passed CPMA
Valerie Fehlman 6/19/2015 Passed CPC
Tricia Allen 6/13/2015 Passed CPC
Kate Balduff 6/1/2015 Passed CPC
Sandra Marroquin 6 / 2015 Passed CPC
Faith Wiegman 6/22/2015 Passed CPC
Jeanne Muller 6/20/2015 Passed CPC
Nancy Zizelman 6/20/2015 Passed CPC
Cheryl Cormier 6/24/2015 Passed CPC
More Congratulations to...
Shelly Thurgood 7/17/2015 Passed CPC
Melissa Barnard 6/27/2015 Passed CPC
Shannon Froning 7/11/2015 Passed CPC
Robin Thompson 6/15/2015 Passed CPC
Susan John 6/29/2015 Passed CPC
Mary Herter 6/30/2015 Passed CPC
Fereshta Porooshasp 6/20/2015 Passed CPC
Anna Vinchkoski 6/20/2015 Passed CPC
More Congratulations to... Jennifer Haduck 6/27/2015 Passed CPC +
Jennifer Haduck 7/7/2015 Passed ICD-10 Assessment
Sandra Bowers 4/18/2015 Passed ICD-10 Assessment
Jen Fowler 7/1/2015 Passed ICD-10 Assessment
Lori Holtzinger 7/5/2015 Passed ICD-10 Assessment
Everett Barker 7/8/2015 Passed ICD-10 Assessment
Charlotte McLaughlin 7/12/2015 Passed ICD-10 Assessment
Lori Conley 6/23/2015 Passed CCO PBC
Marilou Yu 6/16/2015 Got a J-O-B !!
ICD-10-CM Official Guidelines for Coding & Reporting
ATTENTION: FY 2015 - NEW CHANGES NOW POSTED
http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2015.pdf
How to read the document:● FY 2015 Narrative changes appear in bold text ● Items underlined have been moved within the guidelines since the FY 2014 ● Italics are used to indicate revisions to heading changes
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CPC, CPC-I, CRCLaureen Jandroep
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● Tammy: Conversion of dx codes to DRGs
● Tammy: Auditing Question
● Alicia: Fracture Coding
● Alicia: ICD-10 initial encounter vs. subsequent
● Alicia: Struggling with Rule of 9's
● Laureen: Back to Basics - Coding Contrast
● Laureen: Transbronchial Biopsy
● Laureen: Coronary Arteries
Coding Q and A | July 2015
Conversion of dx Codes To DRGs
Question:
How do I convert dx codes into DRGs?
ANSWER
Auditing Question
Question: Is there any way I can get some insight on an audit situation?
Established patient came in for an earache. History documented was comprehensive. Exam was EPF. In the MDM, this was new problem to provider, with no additional work up planned, which is 3 points. The complexity and data reviewed is minimal. No lab, x-rays ordered. The risk was moderate. There was a prescription wrote for the ear. This is sort of a gray area. The presenting problem is straightforward, but the documentation supports moderate medical decision making. Should this be a 99212 or 99213, using exam and mdm as the components for choosing the level?
ANSWER
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
Question: I am looking for help in fracture coding. Is there a good webinar? Suggestions?
ANSWER
Fracture Coding
The Rule of Nine’s
Question: I am struggling with the Rule of 9’s. Can you explain burn coding from and ICD and CPT perspective?
ANSWER
I saw a YouTube clip of you explaining the administration of contrast and made it look much easier with the chart. I'm unable to locate it at the web address on the slide. Is this chart still available?
I'm studying for my CPC and I'm finding the youtube clips very helpful. I'm a verbal learner and appreciate this resource.
ANSWER
Back to Basics - Coding Contrast
Transbronchial Biopsy
Question: How would you code a transbronchial biopsy of the left lower lobe of the lung with BAL washings, but with no lung tissue identified on the pathology report?
ANSWER
Coronary Arteries
Question: I am Confused with major coronary arteries questions. Can you give an example of questions with the answer as 92933-RC, 92934-LD.
One of the practice exam questions gave an example of question with an answer : 92933-RC, 92933-LD. I need more clarification on how to answer correctly the questions from major coronary arteries.
ANSWER
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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
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Questions In The Chat
ANSWERS
Links Referenced in the Webinar
MCB Bundle - http://go.cco.us/medical-coding-billing-course-bundle
Administration of Contrast Chart - http://www.cco.us/administration-of-contrast
Bronchoscopic Alveolar Lavage (BAL) -
http://www.olympus-me.com/medical/en/medical_systems/applications/pulmonology/diagnostic_bronchoscopy/bronchoscopic_alveolar_lavage__bal_/bronchoscopic_alveolar_lavage__bal_.html
PCI Coding Forum Post -
http://www.cco.us/forum/threads/major-coronary-arteries.2871/
Links from Alicia’s slides
http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2015.pdf
http://www.symbiosisrcm.com/understanding-burn-codes-just-made-easy/
http://my.firefighternation.com/forum/topics/889755:Topic:
Links from Laureen’s slides
http://www.cco.us/administration-of-contrast
http://www.olympus-me.com
http://www.findacode.com/code.php?set=CPT&c=31624
http://www.cco.us/forum/threads/major-coronary-arteries.2871/
CCs, CIC/COC?
Most of the job openings that I see are for ancillary positions. Do you think it's better to get the CCS (which is
what most of the entities ask for) or the CIC/COC?
CCS or CPC
Can you please talk a little about taking the CCS examination through AHIMA versus the CPC examination through AAPC. I have my CCA, but since finding CCO, I
am thinking I should change direction and go for the CPC. Please advise...
Guidelines ICD9/10 and CPT
What is the best way to learn the guidelines in ICD9, and CPT I know there are parathencial notes help. Any advice would be helpful.
Can you explain to me the difference between the CPT and the ICD-10 Coding?? Thank you!!
E&M Level
Is there a short cut to determining the level of care for E&M codes from a scenario that does not give the level of
hx, exam and mdm?
HMO and Medicare
If pt. has HMO plan as primary and Medicare as secondary, and the provider is not participating with HMO
plan, but is a Medicare provider, can I bill Medicare?
Burns
Alicia on the Lund Brower Diagram do you add the total numbers together to get the percentage of the burn?
If a patient is re-admitted for additional skin grafting for a non-healing burn, is the ICD-9 coded as a non-healing
wound or a burn?
ICD-10 Diabetes
Alicia, ICD-10 guidelines state that if the TYPE of diabetes is not documented then the default is Type 2
DM. Does this guideline apply to a patient that is pregnant? Or would you code UNSPECIFIED diabetes in pregnancy instead of Type 2 diabetes in pregnancy when
the type is not documented? We run into ER patients who are pregnancy with a past history of "diabetes".
Thank you!
HCPCS for BLS Emergency
What HCPCS code is reported for BLS emergency ambulance service for an automobile accident victim from the accident to the hospital, when the ambulance starts
out from the hospital? The rationale said that the Ambulance Modifiers are in the front of the Ambulance section and I simply don't see them. Help! Thank you!