Putting learning ICD-10 off? CMS wants you to take preparation seriously.

While some practices have tucked ICD-10 readiness into the backs of their minds, CMS wants to keep it on the forefront of yours.

Although the ICD-10 utilization deadline isn’t until October 1, 2013, CMS continues to remind practices that preparation now will prevent desperation in 2013. To that end, CMS has introduced a free service that allows you to receive an email notification whenever the information on its ICD-10 page is updated. Therefore, when the agency announces an ICD-10 webinar, transcript, article, or tip sheet, you’ll get a notification via email to check the site for more information.

Most recently, the site posted an executive summary of its April 27 ICD-10 vendor conference, at which vendors told CMS that “they have implementation plans in place for both Version 5010 and ICD-10, and are confident that they can meet the implementation deadlines.” However, vendors did express concern “that there is no testing period for ICD-10 prior to the Oct. 1, 2013 implementation deadline.”

To that end, vendors were eager to hear about what the payers are doing to prepare for ICD-10, because any snags on the MAC side could slow payments to practices.

In addition, vendors noted that medical providers — particularly those in small- to mid-sized practices — aren’t focusing on ICD-10 yet, but the vendors strongly felt that providers should prepare now for the transition, because “if you do not comply, you will not be paid.”

For more information on ICD-10, visit www.cms.gov/ICD10/02b_Latest_News.asp.

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Avoid getting stuck in the non-management rut.

Are you ready to take the next step in your medical coding career, but you’re not sure how to grab your boss’s attention and show him you’re ready for upper management? No problem. Follow these tips:

1. Do your job well. There’s no reason to give you more responsibility if you can’t handle what you have now, right? Get your superiors to notice your potential by excelling in your current supervisor position. Turn parts around in your department faster than other departments, maintain a perfect quality record in your department, and do your best to keep your department accident-free.

2. Do your homework. Learn more about what upper managers do in your company. Find out what their responsibilities are. If you know someone outside of the company in a managerial position, ask him to describe his job to you. You want to get a sense of whether you can handle the job.

3. Develop people skills. Your ability to get along with and effectively manage people will be even more important when you’re in a higher position. Respect your employees, be diplomatic with supervisors from other departments, and get your workers to work hard for you because they respect you, not because they’re afraid of you.

4. Show initiative. Unless your boss is a mind reader, he probably has no idea you’re looking to move up the ladder. Show him that you’re ready to move ahead by offering to help with projects like managing the year-end new code training, by volunteering for any opportunities like planning the company picnic, or by working on an employee-relations committee.

5. Ask. Show your boss that you’re really interested by asking him what opportunities are available. Don’t wait for him to come to you. Even if no positions are immediately available, he’ll keep you in the back of his mind when a position opens up. And because most companies like to promote from within, you’ve got a good chance.

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Try these easy networking tips for shy people.

Networking is high among conference attendees’ list of benefits. If your shyness might be preventing you from reaching out to fellow medical coders, pull yourself out of that corner and try these networking tips:

• Realize that you’re not the only one who’s shy. Even big executives can be shy people. The next time you’re at a coding conference event, scan the room for someone standing by herself. If she were an outgoing person, she would probably be mingling. Chances are, she’s a shy person who’s waiting for someone to come talk to her. Take the opportunity.
• Enlist your extroverted friends’ help. Stick around your more outgoing coworkers at conference events and meetings, and get them to introduce you to fellow coders or coding consultants. They can help you start the conversation and back you up during moments of silence.
• Practice networking skills at your next family reunion. Chances are, there are many members of your family who you don’t know well. Think of your family reunion as a conference. Walk over and introduce yourself to your family members who you don’t know very well and strike up a conversation with them.

You’ll build your skills to do that at your next coding conference.

• Find ways to have people come to you. Volunteer to be a greeter at the next big meeting or conference. Attendees can just come straight to you. All you have to do is start the conversation.
• Look for ways to break out of your shell a little. Constantly look for ways to build your conversational skills. Read up on the subject, and strike up a conversation at work with coders you don’t know that well. Pop culture, anyone? The opportunities are out there — you just need to grab them.

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Tessa Bartels

“Being a coder is a lot like being a detective.”

Medical coders: If you feel like you’re someone who can work miracles with a magnifying glass, trench coat, and your coding manuals, then you have a lot in common with F. Tessa Bartels. But if you’re not following this ever-changing field, you could be letting your inspection skills go to waste.

With CPC and CEMC credentials, Bartels is currently the reimbursement manager at the Medical College of Wisconsin in Milwaukee, WI. Her career started there in 2000. She has also worked as a coder in pediatric critical care. In other words, she jumped into coding and never looked back.

Here’s what happened. Prior to working at Medical College, she had a career as a travel consultant but needed a change. She took a position as a transcriptionist at the Medical College — but only did that for about two days before being introduced to the world of coding.

“It was my second day on the job. My supervisor told me she was going to have the person who did the coding cross train me, so that in the event of her absence, I could fill in,” explains Bartels.  “Little did I know that this coder wasn’t just planning a short vacation, she was leaving her job. In any case, I jumped into her job and found that I absolutely loved it. I applied for and was granted a transfer.”

So, what do you enjoy about your job? “I really enjoy the variety of work; the interaction between a wide range of professionals and the public; and the  ’problem solving’ (it feels a little like detective work at times).”

How did the TCI training camp help you? I had taken a basic coding course offered by the Medical Society of Wisconsin, but my experience was really limited to a highly-specialized practice (pediatric critical care). When I applied for my current position, a requirement was that I had to get my CPC within six months. The Coding Boot Camp was invaluable in preparing me for the exam because I learned specifics in areas where I had no experience (i.e., radiology, cardiology, OB/GYN); I passed the exam on the first try!

Have any advice for people interested into going into this field? Understand that this is an ever-changing field. No matter what your level of experience or expertise, there is always something new to learn. Be open to challenging your ways of doing things. Also, you will need to interact with a wide range of people – physicians and other healthcare providers, managers, co-workers, insurance representatives, patients and more. Always be professional in your demeanor, work ethic, appearance and don’t forget to maintain your CEUs and certification.

Tips for exam taking. First – prepare by using practice exams. Don’t over think the responses. Pay close attention to guidelines. Answer all the questions that you feel confident about first, and then go back and tackle those that require more thought.

When Tessa isn’t coding, you will probably find her at one of her four (yes, four) in-person book discussion groups, or chatting online with one of three. She’s a voracious reader and an active community volunteer. She serves on two non-profit art boards and enjoys going to the theatre and musical events with her husband. She also loves to travel and to cook. “My husband and I will eat anything (at least once) that isn’t moving too fast,” she jokes.

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If you’re baffled by something, admitting it may impress your colleagues.

You’re surrounded by experts, including medical experts, billing experts and management experts. But you’re an expert too. Sharing your expertise with others is an art form in itself. Some of the world’s greatest experts never learn this art, but it’s easy.

Just remember to:

Tell the truth. Don’t exaggerate what you know, or make up an answer when someone asks you a question. Don’t be afraid to admit you don’t know the answer to a question. Real experts always admit when they don’t know something. Just ask Supercoder Girl about peripheral vascular coding.

Keep it simple. Whether you’re explaining a complicated filing system or a medical procedure your office performs, use plain language and simple sentences. Break the subject down to the basics and go through it in simple terms. If someone has to hide behind jargon and can’t explain a concept simply, chances are that person is only a pretend expert.

Speak up. If you know what you’re talking about, don’t hide your light. Share your expertise with others. Be confident, but not cocky. Real experts are humble but forthright.

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A smart registration process can prevent claim-submission headaches.

If you’re trying to grow your practice, you’ll need to have a logical, simple form to obtain data from your new patients. Not only is a new patient form valuable for gathering important insurance information, but it can help you find patients who owe your practice money and perform collection activities when the patient is present.

If it’s been a while since your practice updated its new patient registration form or you’re creating one for the first time, follow these expert suggestions to make sure you can find patient billing information quickly and easily:

1. Keep the Form Simple

Ask key questions on the patient information intake form that you require all new patients to fill out. Make sure you have basic demographic information such as:

• The policy name and number
• The insured’s name
• Social Security number
• Dates of coverage
• Secondary-insurance information (Households with more than one income often have more than one insurer. The patient must designate which payer is primary and which is secondary.)
• Guardian or responsible party name
• The name of the person or physician who referred the patient.

It may seem obvious, but if your form does not ask patients for their fax, cell phone number, or e-mail address, you could be missing out on valuable information.

Heads up: Limit questions to patient demographics and insurance information. Usually, the form should not include any questions related to medical conditions; its purpose is insurance and payment-related information and/or general marketing data.

Best practice: How you request this information often determines how willing patients are to complete the form. If your request is firm and professional without being aggressive, chances are you will get your required information. “The more patient-friendly and simple and concise, the better,” says Zia Clarkson, a billing consultant and educator in Long Island, N.Y.

Having patients update their forms every year is crucial, as is keeping records up-to-date in case of an audit.

2. Copying the Insurance Card is a Must

In addition to having the patient fill out the new patient form, be sure to ask for, and make a copy of, his insurance card. “Always make a copy of the patient’s insurance card, front and back,” says Brian Fornataro, a billing professional with Medi-corp in Cranford, N.J. “This contains vital information on where to send the claims correctly the first time, cutting down on denials and obtaining revenue faster,” he says.

Since you’ll make a copy of the insurance card’s front and back, you don’t need to ask the patient to provide that information (policy number, group number, phone numbers, etc.) on a form.

Tip: You should ask for the card upon each and every visit by the patient. Insurance information can change frequently, and the patient may not even be aware of the change. “Some payers have different addresses for different specialty billing,” Fornataro points out.

Hint: Make an enlarged copy of the insurance card on your copier. This makes the small print much easier to read.

3. Get Referring Physician Details

When a new patient arrives because of a referral, be sure you have clear information on the referring physician as well. When the patient arrives, a staff member should be reviewing referral data for accuracy. Be clear, Clarkson says. Ask questions such as, “I see Dr. Jones referred you. Is that Dr. Donna or Dr. John Jones?” Clarkson advises.

4. Move Your Forms Online, Too

Consider offering an online form that your patients can fill out before even coming to your office. “Being able to register with the practice online is a great way to have patients offer demographic information,” Clarkson says.

Patients can fill out the forms in the privacy of their homes, where they have all the necessary information readily available — insurance and Social Security cards, for example.

Secure Web-based forms also reduce patients’ waiting time in your office.

If Web-based applications are not an option for some patients, consider mailing out a paper copy in advance — up to a week or two if possible. The patient “can review it and fill it in at their leisure” and submit or return it to the office ahead of time or bring it to his appointment, Clarkson says.

Pointer: Still not sure your forms are hitting the mark? “Have someone outside the practice look at the forms, and get feedback,” Clarkson says.

5. Make Your Practice’s Information Available

The patient will be more open to sharing data with you if you openly communicate office policies and procedures. You may want to discuss with the patient the following:

• Basic services for the condition and your practice’s fees
• The patient’s financial responsibility for services provided during the initial visit
• An estimate of the costs for a new comprehensive history and physical examination
• How the patient can pay for the initial visit (HMO/PPO copay, cash, check, credit card)
• Future-visit payment policy
• Whether the patient needs financial counseling before the visit.

@ Medical Office Billing & Collections Alert

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Laureen’s tips will have turn that clock from foe into friend.

We’ve all been there: the test, the paper, the ticking of that pesky clock. When it comes to the CPC exam, time management is of the utmost importance, because if you don’t allot your time appropriately then all that studying will go to waste.

Guest columnist, Laureen Jandroep, OTR, CPC, CPCEMS, CPC-H, a CodeRyte coding analyst and senior instructor for New Jersey-based www.CodingCertification.org, has the solution.

Follow These Laureen’s Advice for Timed Success:

I’ve been teaching medical coding since 1999 and many students that have come to my review class have said they took a course, attended a boot camp etc. and still did not pass the exam. For those students it is no longer a matter of studying – it is about how they take the test.

For the CPC exam, sponsored by the American Academy of Professional Coders (AAPC), it is divided in three sections. You need to pass each section to pass the entire exam. So you could go really slow in the beginning and ace the first section, pass the second section but due to running out of time fail the third section. The exam is pass/fail – not about getting an A. So you need to spread your success and pass each section.

One Hour – Two Hour Method

When you open your exam you’ll find an answer grid with three columns containing 50 questions each. Allow yourself an hour for each column – two hours for the one with the surgery questions. So that will be four hours of the 5.5 hour exam. You can ask the proctor to announce as each hour elapses.

So when hour one is over and the announcement is made you finish the question you are on and move to the next column – so question 51. Yes, you will have unanswered questions in column one – that is ok – you will go back. The idea is to spread your success across each section. When four hours has elapsed take a deep breath and scan your answer grid – which column has the most unanswered questions? Spend time on that column first and spread your remaining time accordingly on you unanswered questions. This method will improve your chances of having enough correctly answered questions in each section.

One Dot – Two Dot Method

Answering an easy peasy medical terminology question carries as much weight as a time consuming surgical question. In addition to the above method you can rate questions you’ve started to answer but decided to leave them for later and answer easier questions first. In the margin of your exam grid put two dots if you feel it is a very hard time consuming question, one dot for a medium difficulty one. Now when you have your last hour and a half you can go right to the one dots – leaving to two dots for absolute last.

Don’t Leave Any Questions Unanswered

Use the last 20 minutes to guess at an answer on any unanswered questions. You have a 25% chance of getting it right without even looking at the question. Of course if you’ve looked at the question and thrown out an answer or two indicate that on your answer grid so now you may have a 50/50 chance of getting the answer right.

– Thanks to guest columnist, Laureen Jandroep, OTR, CPC, CPCEMS, CPC-H, a CodeRyte coding analyst and senior instructor for New Jersey-based www.CodingCertification.org!

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Kathleen Goodwin with daughter Sadee.

Kathleen Goodwin, CPC, Coding Coordinator, La Porte Regional Physician Network, La Porte, IN is no stranger to change, so that’s why trading a television career for one in coding, was no big deal.

“I’ve been with La Porte for a little more than two and a half years now and I love it,” Goodwin says.

Prior to this position, Goodwin worked as a billing representative and moonlighted as a bartender.

“I try to make up for my limited industry in the field, by reading and learning from every reputable source I can get,” Goodwin explains.

So, what makes a person leave TV for coding? “In another life I was a reality television producer. I have a bachelor’s degree and was always involved in production (it was my minor in college), so it was natural for me to continue after school. However, I was looking for a different career – one more conducive to family,” Goodwin says. After researching different positions in the healthcare field, she knew coding was for her! She took classes at a community college and got a billing and coding certificate. While she is not currently a certified coder through the AAPC, she is planning to attend training camp and is taking the test this summer. “I’m anxious and excited at the same time,” Goodwin adds. “Being certified by the AAPC is the most credible certification; the AAPC is kind of like the Harvard of coding.”

The Code Tells a Story

Goodwin enjoys the very specific, detail-oriented work that is involved. “I also like the research and doing internal audits. When you code properly, the codes tell a story of what happened during the encounter. These are traits I could transfer from my prior career,” Goodwin explains.

Goodwin Offers New Coders Advice

“First, realize that it’s hard work,” Goodwin says. “There’s a lot of research involved and it’s very detail oriented. As much as you research, you will never know all the rules. There is no finish line. Codes, policies, and compliance rules change all the time. There are times when you educate your office staff/physicians only to turn around and say, ‘Remember what I just taught you? Yeah, forget that but now, remember this.’ ”

The Road Ahead

Goodwin reflects that her life thus far has been interesting. Raised in a small in Northwest Indiana, she has worked as a wolf/hybrid handler and trainer, volunteered at animal rescues, lived in Chicago and Los Angeles and worked in television. “I like to think that yet a different life is before me,” Goodwin says. “I’m recently married and we were lucky enough to be blessed with a healthy baby girl who is almost a year old; I’m in a career I enjoy; and I’m always learning – life is good.”

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]]> http://codingcareer.inhealthcare.com/my-virtual-mentor/coding-superhero-from-reality-tv-to-the-wonderful-world-of-coding/feed/ 0 http://codingcareer.inhealthcare.com/my-virtual-mentor/coding-superhero-from-reality-tv-to-the-wonderful-world-of-coding/ http://feedproxy.google.com/~r/codingcareer/~3/2XCmPGlLxk8/ http://codingcareer.inhealthcare.com/my-next-step/how-to-climb-the-corporate-ladder/#comments Thu, 13 May 2010 06:58:18 +0000 Editor http://codingcareer.inhealthcare.com/?p=388 These five proven ways will really impress your boss and land you a raise.

Have you ever asked yourself, “I love my job but would like to begin moving up within our office structure. How can I get noticed by…

These five proven ways will really impress your boss and land you a raise.

Have you ever asked yourself, “I love my job but would like to begin moving up within our office structure. How can I get noticed by my supervisor?” One of the fastest paths to promotions and pay increases is to impress your manager.

This doesn’t occur by insincere compliments or shallow brown-nosing, but by doing what you can to make his or her job easier and your coding office run more effectively. Here are five proven ways to impress your manager.

Excel at the fundamentals. Do the job you are paid to do as well as you possibly can. The manager will then have to spend less time following up on your work and correcting mistakes. You want to be the employee she can count on to do the job right the first time.

Be the rabbit. When your manager announces a new process or program, fully embrace the changes and run with them. This gives your manager powerful proof that her ideas can pay off. Your success will then be pointed to as the example of what others can do.

Ask for more. Amaze your manager by saying, “I occasionally have an extra 10 minutes during the day when all my work is completed. Is there something else you’d like  me to do for you during that time?” This extra work might increase your responsibilities and authority.

Confide in your manager. You increase your chances of promotion just by telling your manager you want to succeed. Ask what you need to do to reach your goals and then do what is requested. Your manager will now consider you when future opportunities arise.

Show loyalty. Remember that your top loyalty is to the practice. Refrain from water-cooler conversations that badmouth your manager. If you detect workplace theft, co worker harassment, improper safety procedures or other negative behaviors, alert your manager.

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It’s your worst nightmare: Not only are you forced to recall poor fashion choices of the past, but you’re facing an audit. Maybe the headband had you thinking that you could bill a consult, but you know what the difference is now that Medicare no longer pays for these services. But ‘now‘ doesn’t mean a lot to an auditor.

Bottom line: If an auditor comes calling and wants to review your consult notes, he will be judging you based on the Medicare rules as of the date of service.

Some coders assume that any audits taking place in 2010 or thereafter that involve consult notes will be based on CPT consult rules, and not Medicare’s, since Medicare does not recognize consult payment as of 2010. Because Medicare’s consult regulations were generally more strict than CPT’s, practices consider this a small victory. But this is inaccurate, experts say.

“If the auditor is reviewing services you performed in 2009, CMS rules from 2009 will apply,” confirms Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC with CRN Health-care Solutions in Tinton Falls, NJ. “In 2006, Medicare changed the rules — so if they audited 2005 consult services, it would be a different standard than 2009 services as well,” she says.

Requests for Notes May Follow

The Medicare auditor may not just want to read your physician’s notes, but may even request notes from other practitioners if it’s necessary to back up your claims.

“In evaluating consults, I have even experienced one audit where they also requested the referring physician’s documentation to substantiate the reason for the consult,” says Devona Slater, CHC, CMCP, president and compliance auditor with Auditing for Compliance and Education Inc. in Leawood, Kan.

“Medicare’s definition of a consult and the CPT definition have always been different and a reason for confusion,” Slater says.

Slater says she has seen auditors who find that practices don’t have adequate consult documentation “downcode the consults to new or established patient visits and request a refund for the difference.”

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