Advice

4 Proven Ways To Stay Up To Date In The Medical Coding Industry

 It's not secret that the medical coding world is always changing. Every year there are new codes and new guidelines. You have to buy new books and read through the new codes and make  sure you understand them. But there is more to it than that. You have to continue on with your own professional growth and development in your own specialty and maybe even learn about new specialties. So how on Earth do you do all this on top of everything else going on in your life? Here is a list of 4 ways to help you keep up with the ever changing medical coding world.

 

  • Read medical coding publications. I'm sure many of you read AAPC's magazine to get the 1 CEU credit. But it is a good idea to read this magazine anyway. There's lots of good articles here that will keep you up to date. Not just coding but overall changes/trends in the industry so you're not left in the dark.

 

  • Go to AAPC meetings. I know I'm talking a lot about AAPC here, but that is because it is what I'm familiar with. Every month there are local chapter meetings, and if you go you will get to network with other coders and also earn CEU's. I hate to say this, but it took me years to go to meetings because I just couldn't do it. My kids were young and I just couldn't swing it. However, at the time I did sign up to be on their email list. So I kept up that way for a while until I could finally make the meetings. I'm not sure if AHIMA does something similar. If you are certified through them, definitely look into it and see what they have to offer.

 

  • Network with other coders. If you can't get to AAPC meetings, another way to network with coders is online. If you're part of Facebook medical coding groups, you will have the opportunity to just talk to other coders and see what's going on in the coding world in general. Make a long story short, some of the best coders I know, I have not met in real life. But I've known them through Facebook for years and I consider them not only peers, but good friends.

 

  • Always look for ways to expand your own knowledge. This could be hard to do, but one of the ways you can stay up to date with the coding world is to keep an eye on other specialties that you're not currently coding. For example, even if you're not an E/M coder, big changes are coming in the next few years. It helps to keep up with these things just so your knowledge overall stays relevant, and you know what you're talking about. Here's another idea too. Get books and read up on different specialties if it's something you're interested in and just want to learn it. For example, even though I only audit diagnostic radiology, I've been spending time reading up on interventional radiology. It takes a long time to learn and I'm no where near ready to code it in real life. But it's something I'm interested in and might want to do someday, so I figure, why not.

Anyone else have any other suggestions? What do you do to stay up to date in the coding world?

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

Practice Report To Code

Practice Report To Code

For the blog post this week, I thought I’d share a report to code. This is a HIPAA compliant report and does not contain any PHI. Answers included at the bottom. Please feel free to comment or email me at midnightmedicalcoding@gmail.com if you have any questions 🙂

 

 

Ok- what do you think the ICD-10-CM and CPT codes are for this report?

Ready for the answers? Scroll down the page…

 

 

 

 

 

 

 

 

 

 

 

 

 

Thanks for those of you who participated in this!

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

 

 

 

 

 

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News

Eli Global, LLC Charged With Public Corruption and Bribery

Ok, you might have read the title of this post and wondered why I’d even be writing about this. This is after all a medical coding blog right? Eli Global, LLC probably does not ring a bell. At least for me it didn’t when I first read about this. I was like Eli Global, LLC? Never heard of them. Moving on.

But here’s the thing. Eli Global, LLC is a huge company that has many companies under it’s umbrella, and one of those companies is AAPC. You’ve heard of AAPC right? AAPC is one of the main organizations that certifies coders and many of us (myself included) have gotten at least one coding certification through them over the years. So, the owner of Eli Global, LLC (and also AAPC) is under investigation now for different illegal things.

I don’t want this post to be about my opinion on this. I’ll go along with the whole innocent-until-proven-guilty-thing, but I have to admit, this is concerning to me. I’ll post links to some different articles and you can form your own conclusions:

Articles:

The United States Justice Department

Subpoena 

Insurance News 

The Hill

Triangle Business Journal

Well, maybe I’ll just put one of my opinions in this post and that’s it. So, in order to be a certified coder, it is just expected that we have high standards. AAPC even has a Code of Ethics. Here it is:

Code of Ethics

AAPC has a code of ethics which addresses coding professionalism and compliance integrity. The eight components of AAPC’s Code of Ethics are:

  • Maintain and enhance the dignity, status, integrity, competence, and standards of our profession.
  • Respect the privacy of others and honor confidentiality.
  • Strive to achieve the highest quality, effectiveness, and dignity in both the process and products of professional work.
  • Advance the profession through continued professional development and education by acquiring and maintaining professional competence.
  • Know and respect existing federal, state, and local laws, regulations, certifications, and licensing requirements applicable to professional work.
  • Use only legal and ethical principles that reflect the profession’s core values, and report activity that is perceived to violate this Code of Ethics to the AAPC Ethics Committee.
  • Accurately represent the credential(s) earned and the status of AAPC membership.
  • Avoid actions and circumstances that may appear to compromise good business judgment or create a conflict between personal and professional interests.

Hopefully it’s not too much of a stretch for the owner of AAPC to follow it’s own Code of Ethics. I’ll leave it at that.

Thanks for reading.

-Lindsay Della Vella BS, COC

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

 

 

 

 

 

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Advice

3 Things Your Medical Coding School Did Not Tell You

Ok, before you even read this post, please keep in mind that this post is not about one specific coding school. There are literally hundreds of medical coding schools out there and some are undoubtedly better than others. This post is just my response to social media threads I see out there where people talk about dropping thousands of dollars on a medical coding course/school and still had no idea they needed to take a certification exam. Had no idea it would be hard to get a coding job. And who also had no idea that working from home shouldn’t just be an expectation. That is only the tip of the ice burg. It saddens me to think that coding schools do not give their students the heads-up about the real coding world. But it also bothers me that some (not all) potential coders do not research and do their homework and look around. It’s important to at least get a feel for the coding world before jumping into it. So, in case your new to the coding world, please read this list below. It might help you decide if coding is really right for you.

 

“School coding” is not the same as coding in real life. Let me explain. When you are in coding school, you are still just learning. You are in the process of forming the foundation for your future. It’s important that you get an overview of all the different areas of coding, and get a basic understanding. So since the goal at this point is learning how everything kind of goes together, everything will be presented to you in a way that’s clear without leaving much room for guesswork. An example would be–if you have an E/M coding question–it tells you right in the question what all the different levels are for each area. You don’t have to fill out the actual audit sheet and get the level yourself. This is okay–you are learning and it’s not expected that you can do this right off the bat. It bothers me though that coding schools don’t seem to let students know that it is not like this in real life. Don’t get me wrong–some doctors are better than others about documentation and sometimes the report is very clear and easy to understand. Other times, well, not so much.

 

The next thing many new coders don’t know is very similar to the last one, but has to do with insurance. Different insurances have different rules. Many coding schools do not even mention the idea of insurances. I can see why they wouldn’t. You are learning how to code and it’s probably best not to complicate things by throwing the idea of insurance and different rules into the mix. Again though, I think it would be beneficial to the student if this is at least mentioned at some point. An example off the top of my head– some insurances still use a modifier 59. Some don’t, and use the different X modifiers. Some even have rules that would sound weird to a coder. An example would be, I remember there was one particular insurance that required a 59 be added to both a 76856 and 76830 on the same claim. The CPT book would say this is a no-no, but that is how this one insurance wanted it. I’m sure there are many more examples out there. The point being though–insurances have rules. It’s not expected you know them right out of the gate, but I wish schools would tell new coders that this is actually a thing. Once you throw federal payers into this (Medicare)–they have rules too. Many insurances follow what Medicare does, but some do not. You will learn all of this on the job, but again, this is something just to be aware of.

 

 

 

Ok, one last thing that new coders may not realize is that working remote is not a guarantee. Many schools try to sell the idea that you can work from home from day 1 and make lots of money all while tending to other things. Sometimes these schools even have a picture of a young mom coding with her baby sitting on her lap. This makes my blood boil. Yes, some people have been fortunate enough to work from home from the beginning. Is it the norm? No. And while taking care of a baby? Definitely no. I feel like they just put pictures like that to sell you on the idea that you can stay home, raise your kids, and work at the same time. And they make it look easy. I won’t go on a tangent too much here, but I heard a saying once and it kind of stayed with me. It said, “Women are expected to work like they don’t have kids, and raise kids, like they don’t have to work.” I know there are million different situations out there, and yes, it is possible to work from home and still have kids. That’s not what this is about. I don’t like how schools set people up with the idea that it’s an expectation and everyone and anyone can do it.

 

Anyway, all I can say is just do your homework before getting into the field. It is a great field to be in, with many different possibilities. I absolutely love it, and I can not even see myself doing anything else. A great way to get an idea for what it is really like is by networking and talking to other coders. They can also share their experiences. It may even lead to a job offer down the line. You can go to local AAPC chapter meetings and join different coding Facebook groups out there to meet other coders.

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

 

 

 

 

 

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Questions

Diagnostic Radiology Coding Questions?

Hey Everyone,

For this weeks blog post, I thought I’d have you guys ask me questions. What questions do YOU have about diagnostic radiology coding? It can be about CPT, ICD-10, guidelines etc. Is there anything you’d want me to answer? Please post in the comments below or send me an email at midnightmedicalcoding@gmail.com.

I’ll post the questions and the answer in the blog post for next week.

 

Thanks!

 

 

 

 

 

 

 

 

 

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

 

 

 

 

 

 

 

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Diagnostic Radiology Coding Basics

10 Things You Need To Know Before Coding Diagnostic Radiology

For this week’s post, I thought I’d talk about just some general things relating to diagnostic radiology coding.  Bear in mind, this isn’t the be-all-end-all, everything-you-need-to-know guide. This is just what I would tell a new coder who had limited experience with this specialty in a nutshell.

  1. First things first–radiologists can be vague in their documentation. They like to use words like “consistent with,” “probable,” “rule-out” etc.  In the outpatient setting–you do not code uncertain diagnoses. So if you come across a report with these terms, do not code it. A common phrase I see in the impression on chest x-rays is “consistent with pneumonia.” Since it is not definitive, you would not code the pneumonia–you would code whatever the symptoms are. There is a coding clinic however that states that the use of the words “Evidence of” is not a vague term–so you can code the condition.
  2.  When you’re coding, refer to the impression. If there is a finding, it will be listed here, and this is where you code from. If there are no findings, you would code the history/symptoms stated on the report.
  3. When you’re coding x-rays, you count up the number of views to get the CPT. Sometimes the radiologists may mention images–do not count images. It is not the same thing as views. (If you want to learn more about x-ray coding, don’t miss the boat on our online class).
  4. Another thing to keep in mind is to always follow all client specific guidelines. For example, do you code an addendum? Do you need to add a modifier 26? All of these types of questions will be answered in your client guidelines. (A good rule of thumb is to review your client guidelines before reaching out to the lead coder for questions).
  5. Know the difference between limited and complete ultrasounds (refer to the CPT book).
  6. Know the difference between all the different OB ultrasounds (refer to the CPT book).
  7.  CTA’s must state 3D in the documentation.
  8. Know whether or not you need to code the contrast for MRI and CT scans. Do you code contrast waste? Again, review client guidelines on these types of questions.
  9. Know whether or not you need to code incidentals. The answer to this is generally no, but this is another client guideline type question.
  10. Last but not least, know how to code fractures. If this is new to you, see this previous blog post.

So there you have it. Hopefully this list helped you figure out a little more about diagnostic radiology coding.

Thanks for reading-

 

 

 

 

 

 

 

Midnight Medical Coding Products You Might Be Interested In:

 

Learn The 50 Most Common X-Ray CPT Codes-

Self-paced online course. Getting awesome reviews from fellow coders.

 

 

 

15 Question Practice Coding Test

Practice coding the ICD-10-CM and CPT codes of HIPAA compliant X-ray reports. Answers and rationales provided.

 

 

 

 

 

Join the Midnight Medical Coding Stars- A membership only area where one HIPAA compliant diagnostic radiology report is added each week for you to code the ICD-10-CM and CPT codes. Answers provided.

 

Join the Midnight Medical Coding Stars

 

 

 

 

 

 

Tabs for the ICD-10-CM Book: Get 60 printed, multi-colored, double-sided tabs. These can be used on any 2019 or 2018 ICD-10-CM book from any publisher.

 

 

 

 

 

 

 

 

 

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CAC

Will CAC (Computer Assisted Coding) Replace Medical Coders?

So, here’s a question I see posted in different FB groups every once in a while–Will CAC (Computer Assisted Coding) ever replace medical coders? There is a long and short answer. The short answer is No. The longer answer–still No, but there’s more to it than meets the eye.

We all know there are some computer programs out there that make coding easier. These programs pick up on key words in documentation and for lack of better word–the computer ‘codes’ it. But here’s the thing-computers may be good at picking up on key words, but they can’t think. Computers are not aware of coding rules and guidelines, modifiers, excludes 1 notes…etc. So what happens is, the CAC just codes whatever keywords it picks up on, but it may be all wrong because it doesn’t know the rules. Here is what I mean:

Sometimes, it codes the reason for the exam plus the findings. According to ICD-10-CM coding guidelines, that is incorrect. When there are findings that explain the reason for the exam, the report is coded to the finding. Another thing I’ve seen CAC software do is put about 5 or 6 diagnosis codes on a simple report, like an abdominal ultrasound. It’s not wrong per se, but really? Do we need to code every single incidental diagnosis? No. Incidentals don’t need to be coded, but I’ll save that for another post.

Here is another common mistake that I’ve seen on audits done by CAC software. If you’ve coded radiology, you know how radiologists love to say “consistent with.” So, say you’re coding a chest x-ray and the report says, “findings consistent with pneumonia.” According to ICD-10-CM Coding Guidelines, you would not code the pneumonia because it is not definitive (this is outpatient coding, by the way. Inpatient coding has different rules on this). Many times the CAC software picks up on the word “pneumonia” and codes it. That is not how that report should have been coded because of the “consistent with.” It would be coded to the symptoms or a definite finding in the report. So, like I said earlier, CAC does not think. Does not know coding rules.

My guess is though (and this is only a guess) is that maybe in the future, most coders will be just checking the codes that CAC software came up with, and having more of an auditing role. Many places use CAC and have success with it, but there are also people checking the codes before it goes out. At the end of the day, there will always be a need for coders. Coders do way more than assign codes based on keywords. We think and have an in depth knowledge that just can’t be replaced by a computer. Besides, would any doctor out there want their billing/coding not even checked by a qualified person before it goes out? Probably not.

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Midnight Medical Coding Stars

Practice Report To Code

Everyone knows that coding takes practice, right? I mean it would be really nice if we just woke up one day, and knew how to code all the different specialties. (I admit I still have nightmares about learning how to code E/M).

 

Looking back, I remember a teacher I had who used to say, “The more you practice, the better you get.” That couldn’t be more true when it comes to medical coding. If you don’t practice EVER, you just won’t become familiar with certain types of reports. The problem is though–practice reports are hard to come by. There’s not too much out there, especially for diagnostic radiology coding.

But have no fear–I have reports that I can share. Each one is a diagnostic radiology report (x-rays, ultrasounds, ct, cta, mri, mra, duplex) For each one, you code the CPT and ICD-10-CM code, and then check your work. I am always available for questions–feel free to email me (midnightmedicalcoding@gmail.com).

So, everyone get a pencil and piece of paper if you’re old school like me, or use a tablet/device to take notes on.

For this report, please code the CPT and ICD-10-CM code.

**These reports are HIPAA compliant and do not contain PHI.

Ready for the answers? No cheating…

 

 

So, did you get the right answers? It’s okay if you didn’t. Remember–all types of coding take practice. Want to have a shot at practicing radiology coding? The good news is–I have more practice reports available! Each week I post a new report for you to code. Right now there are 20 reports available immediately and a new one will be added each Monday.

Join the Midnight Medical Coding Stars. That is a membership-only area where I post all of the reports.

 

I can’t just share these reports with the whole world. This is special and it’s reserved for only certain people. It is only $4.99 per month. That is a steal. That’s less than 1 Starbucks coffee.

 

I hope you’ll join us!

 

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Coding Course

My First Day Working As A Medical Coder

On the first day of my first coding job, I didn’t know what I was doing. I really didn’t. I never coded a real radiology report before. I guess I read a few in my coding classes, but it was something that wasn’t focused on.

Everything I knew about radiology was just based on my life experiences up to that point. I knew what a wrist x-ray was because I needed one before (broke my wrist rollerblading). I knew what an ultrasound was because I have kids and had my fair share of prenatal ultrasounds.

I kind of knew what an MRI was because the machine looked scary to me and I couldn’t see myself ever being brave enough to go in one if needed. I didn’t know what a CT was. Never heard of a CTA or MRA. Didn’t know what spectral doppler was. Needless to say I was confused at my first coding job. I didn’t know what any of this stuff was. I was fortunate enough to have an awesome mentor who helped me with CPT coding and even some diagnosis coding here and there.

But I know not everyone is as lucky as I was. Not everyone has a mentor. Or maybe you don’t feel comfortable asking a coworker for help. Even though I’m not a new coder anymore, I didn’t forget what it was like being new. How I was afraid of coding everything wrong. How I was afraid that I really did not know what I was doing and was not going to make it as a coder.

 

Some of you may know this already–but I’ve put together a new diagnostic radiology coding course. It is geared towards new radiology coders or coders in another specialty who want to learn more about it. It focuses on the CPT coding of x-rays. By the time you finish the course, you will know how to code the CPT for a variety of x-rays. You will be familiar with 50 of the most common ones used and will be prepared for ‘real life’ diagnostic radiology coding. It is all online and self-paced.

Please see the link below for a full description of the course. You’ll see the exact format and what is included. Scroll down the page and you will see a FAQ section and what my students are saying about the class. I hope you’ll join us!

 

Click Here for more info, to see class reviews and to sign up!

 

Click HERE for more info, to see class reviews and to sign up.

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Coding Course

On Sale Now!

Are you a medical coder or medical coding student who wants to learn more about diagnostic radiology coding?

There are A LOT of codes in the CPT book and you’re probably only familiar with the ones you use everyday.

So, if you’re a coder in another specialty, or a coding student, you might not know that much about the CPT coding of x-ray’s just because you haven’t had the opportunity to code them yet, or maybe it’s something that really wasn’t focused on in your regular coding classes.

Our new online coding class is available now! It focuses on the CPT coding of x-rays. You will code HIPAA compliant reports after each lesson and do coding practice exercises, take quizzes (your score is available immediately after submitting it) and there is test at the end. Supplemental info/sources/links are also provided. It is all online and self-paced.

The instructor (me- Lindsay Della Vella!) is available 24/7 through email for questions.

This class is getting excellent reviews from fellow coders who have already completed it. I hope you join us!

It is on sale NOW for $39.99! Offer expires Sunday at 5 pm EST.

Click the link to sign up and for more info.
https://bit.ly/2wSf6hF

Still have questions? Feel free to email me at midnightmedicalcoding@gmail.com