Coding Certification Q & A

Laureen Jandroep, CPCSr. Instructor, CodingCertification.Org

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Who is Laureen?• Graduated with a Bachelors in Occupational Therapy

• Owned and Managed Rehab Agency

• Owned and Managed Medical Billing Company

• Owned and Managed Billing and Coding School - brick and mortar as well as online

• Started National Coding Discussion List "Coding & Reimbursement Network" - now the CCO-L

• Sold Online School which is now operated by AAPC

• Currently works full time for 3M HIS/CodeRyte as a Clinical Development Specialist

• Teaches Coding Certification Review Blitz as well as other coding seminars.

• Has taken and passed the CPC, CPC-H, CCS-P, CCS, RCC and currently maintains her CPC and CPC-I credentials

• Married since 1989 with 5 kids (1 grown step-son and 4 little ones

age 7 and under.

Who is Alicia? • Held several jobs in the medical field from, CNA, EMT, Pharmacy technician

and Medial Records Abstractor, Analyst and Nursing.• Joined the AAPC and became certified as a CPC in 2011• Working towards Masters in Health Care Administration with an emphasis on

education. • Former Instructor at a private college teaching medical coding and billing and

medical law and ethics. • Working now as a remote Medicare Advantage Coder for Optum.• Alicia will tell you that not only does she love medical

coding but she has a passion for teaching it.• Presently Alicia lives in West Texas and is married

with six children (no that is not a typo!)

• Held several jobs in the medical field from, CNA, EMT, Pharmacy technician and Medial Records Abstractor, Analyst and Nursing.

• Joined the AAPC and became certified as a CPC in 2011• Working towards Masters in Health Care Administration with an emphasis on

education. • Former Instructor at a private college teaching medical coding and billing and

medical law and ethics. • Working now as a remote Medicare Advantage Coder for Optum.• Alicia will tell you that not only does she love medical

coding but she has a passion for teaching it.• Presently Alicia lives in West Texas and is married

with six children (no that is not a typo!)

Who is Alicia?

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Student Case Study

Ruth Sheets, CPC-APoughkeepsie, NY

What is the diagnosis code assignment for contraction of the anterior capsule causing the intraocular lens implant to be displaced following extraction of a cataract? The physician uses a laser to repair the torn capsule and reposition the lens.

A.996.69B.996.53C.998.82

Question - Intraocular Lens

Can you explain why X is the correct choice?

ANSWER

V Codes

Can you help us with V-codes - in particular knowing WHEN we would need to add one. For example if we are reading a test question that we need to code the DX and TX how would we know we also need to assign a V-code. E-codes just pop out at you......PT fell at home and broke an arm. Code the break and the E-code. But V-codes are much harder to know just by reading a question that we need to code one. Thanks! Linda ANSWER

Please review casting and strapping coding. I get confused as to when it is bundled and when it isn't.

ANSWER

Orthopedics - Casting & Strapping

Coding for GERDWhat is the difference between 530.81 and 530.11?

530.81 Esophageal reflux

530.11 Reflux esophagitis

ANSWER

Is there a rule of thumb to which code should be billed first if the ICD-9 does not state otherwise? For example 250.40 and 585.3, I understand that, but maybe a good example might be dehydration due to flu. What is the rule to "bill first". My thinking is, you would have the flu before the dehydration, but then my over thinking kicks in and thinks that you wouldn't maybe have an office visit if you weren't dehydrated. Thank you for your help on this biggie. ANSWER

Bill First - ICD Sequencing

Omit CodeCan you please explain the USE of "Omit Code" in the ICD-9?? I just don't get it! If we are not to use this code then why have it in the book?!?!?!

This is what I am thinking it means - can you confirm or tell me what it does in fact mean?

Example in volume 3 ICD-9 Hospital procedures 39.3 Suture of a vessel Then under that it has an "Excludes note" and under that "Omit Code" and it lists other codes like39.52 49.95 57.93 39.41 21.00 - 21.09 60.94 28.7 = does it mean that if I am coding anything from this list that I should not code anything in the 39.3 category as well? ANSWER

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A patient had a debridement and a skin graft in an acute setting. Now patient is at a LTAC hospital. I have two different thoughts concerning what to code.• aftercare following surgery of skin and subq• aftercare for organ transplant

Any thoughts on what to do? Thanks.

ANSWER

Debridement and Skin Graft

Hypertension & Chronic Kidney Disease

ANSWER

CEU's and the CPCANSWER

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