Coding & Reimbursement Network News

From the Founder

by Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS CRN Founder & CEO

Hello CRN Associates!

As you are receiving this newsletter Barb and I are at the Ingenix Essentials conference in Las Vegas. I heard the event is sold out! If you are going to be there, please stop by the CRN booth - # 201. We have a great new brochure to hand out. We will be showing off our recorded TeleWebinars (mini-courses) and demonstrating how to get the most out of the CRN Network. I hope to see many of you there!

Despite last Wednesday being the day before Thanksgiving, we had a good group on the Chat. Thanks to all that participated. Our next chat is scheduled for December 7th at 3:30 PM as we have a TeleWebinar prior to that. See the TeleWebinar Update section for more information.

If you have a group that needs coding certification training, please visit our new web page for group coding discounts. There is a downloadable info pack that is complete with invoices that can be submitted to your "higher-ups".

Enjoy issue #11 and be sure to tell your friends!

--Laureen = )

[top]

Listserv Lately

by Suzan Hvizdash, CPC CRN Senior Auditor, Instructor

We started last week off with an unusual insurance policy. Apparently the patient was injured in an auto accident. The other driver had a few drinks. It was written into the patient's insurance contract that they don't pay for any injuries sustained as a result of alcohol. (I hope I got that right!) This exclusion seemed a bit odd, and more so, difficult to prove. What are the criterion? Blood alcohol level? Number of drinks? Type of vodka? Red or White wine? How does an insurance company determine that their member shouldn't be reimbursed for an injury resulting from a situation beyond their control? Is this fightable? Could these services be billable to the auto insurances? I'm interested to know how this one turns out!

"The most ridiculous denial I have seen" was the title of a long chain regarding insurance companies denying EKGs as being bundled into a knee injection. How can these two procedures be considered related enough to bundle? The insurance company stated that "certain procedures are commonly performed in conjunction with other procedures.and is clinically integral to the successful outcome of the primary procedure." Well, our list was quite vocal on recommendations on how to pursue this one. One poster suggested the lister look at how the two procedures were billed. If both lines referred to both procedures, this type of denial could result. If, however, the EKG was pointed to the chest pain and the injection was pointed to the knee issue, then this is definitely worth fighting. Send a letter to the insurance carrier and make certain you CC the CEO was another suggestion, as this is something they've been called on in the courts recently.

What about the situation where the doctor didn't want to write a complete Operative Note? He was questioning the components of the note and a lister asked for references to help guide the physician.

The new CPT guidelines came out and some returned from the AMA symposium with some new insights. Thanks for sharing! The 2006 Medicare fee schedule was posted this week. Barbara gave us the http://tinyurl.com/akvtb and Don helped by separating the fee schedule into localities http://www.donself.com/documents/2006/2006MFS.html.

To discuss or not to discuss fees, that is the question. Is it "allowed", "appropriate", "legal" to discuss fees on a list serve? This brought in a lot of opinions regarding price fixing, price comparisons, etc. Got conversation, check it out http://health.groups.yahoo.com/group/CRN-L/message/50164.

There were a lot of diagnosis coding questions asked this go-around, including information about the ICD-9, Volume 3. Most everyone got at least one or two responses to their questions. I'm sure they were helpful. If you find you post a question and don't get a response, try again. Everyone is there for you and we certainly don't want anyone to feel they can't come to us with their perplexing issues.

Have a great end of November!

Until next time,

Joining the list serve: $0
Asking questions on the list serve: $0
Advice received on the list serve: Priceless
Reading your bi-weekly CRN newsletter: $0
The value of reading your bi-weekly CRN newsletter: Priceless

--Suzan

[top]

The Coding Sleuth

by Tara Conklin, CPC

It was a dark and stormy night... Don't you just love when a good mystery starts out like that? Sorry, had to do it.

I was just getting comfortable at my desk when the phone rang. Another mystery fell right into my lap; actually it was my coffee when I reached for the phone but no difference. On the phone was a well-respected doctor with a real predicament on his hands. He was getting denials on his cardiac catheterizations and didn't understand what he was doing wrong. I told him I would be right down. (I changed my pants first).

Our investigation led us right into the "heart" of town; the Cardiac Business District. This was where it all happened, the constant flow of commerce.., the heart beat of it all.., okay, okay, I'll stop with the puns.

The office was clean and immaculate and the staff was very helpful. A tall man in a white lab coat introduced himself as Dr. Stan Osis. I stood and he took me to the crime scene. Two separate neat stacks of papers lay in one corner of his desk. One was claims with corresponding EOBs stapled to the back and the other was meticulously dictated operative notes. Each stack was in alphabetical order by patient's last name so the top note corresponded to the top claim.. (hmm very close attention to detail). I dove right in.

I ascertained all of his procedures were done at the hospital as he did not have or own a cardiac lab. He also did not provide any supplies or equipment; this was all supplied by the hospital. Looking through the stacks of papers the first thing I noticed was the absence of modifiers and the misuse of some others. I also noticed there were a few codes missing upon review of the operative note. I sat the good doctor down and decided to break the coding down for him.

Diagnostic caths need be broken down into either diagnostic or therapeutic procedures or many times they are both. Depending on what the purpose of the procedure is will depend greatly on what can be coded.

Next they need to be broken down into corresponding components. Most cardiac caths have at least three codes.
1) The Catheter placement
2) Injection procedures
3) Supervision & Interpretation

The first component is the catheter placement itself. These codes start with 93501 and continue to 93533. They are determined based on the final placement of the catheter into specific heart sites. The two most common are Right & Left Heart Caths. These are coded if the catheter crosses the aortic valve and is placed into either the Right or Left Ventricles. If the catheter is placed into both ventricles then a combination Right & Left cardiac cath code is used based on the point of entry. This is called a "concomitant heart cath". The purpose of this is to obtain the different pressure & measurement recording from the separate chambers of the heart, i.e., arterial, pulmonary, etc. The catheter must cross the Aortic Valve in order to be considered a "concomitant" heart cath.

If the catheter does not cross the aortic valve and is placed directly into the coronary arteries, this is coded with 93508.

Regardless of arteries and heart structures the catheter is placed into, the cardiac catheter code is only reported once for the entire procedure.

Also note the catheter code is done with the use of equipment provided by the hospital, therefore there are both "technical" and "professional" components to the cardiac catheter codes. Dr. Osis informed us he did not own the equipment. Therefore. he would need to append modifier -26 to the catheter codes, as he is only going to get paid for the "doing" portion of the exam.

Once the catheter code is chosen, the next part is to determine the injection procedures performed. These codes report the doctor's work only. The technical component is already being picked up with the catheter code. Therefore, these do not need any modifiers whatsoever. I opened the CPT to show Dr. Osis all of these codes in this section are modifier -51 exempt, which means, they don't bundle and are not subject to the multiple procedure reduced payment rule. (This made him very happy).

I pointed out the injection codes start at 93539 and end at 93545. Each code is used to report injection(s) done in specific portions of the heart. For example, 93539 is used if injections are performed of arterial conduits such as the internal mammarys and are used regardless if these conduits are native or have been placed by way of coronary bypass surgery. It may be necessary to cross through the Subclavian artery in order to perform injection of the LIMA or RIMA (left/right internal mammary artery). When this is done, even though the catheter has left the heart structures itself and has gone up and over into the great vessels that lead to the head and arms; if the purpose of the injection is specifically to visualize the LIMA or RIMA, 93539 is coded in lieu of 36215/36216 and/or 75710 since these are coded for diagnostic purposes of the peripheral arteries, not the heart. If separate injection of the Subclavian or any vessel outside of the heart is performed to diagnose non-cardiac conditions (i.e., peripheral stenosis), the 36215-36217 codes and their corresponding 75000 codes may be coded separately. We'll get more into these later. If you get confused always ask yourself "What is the purpose of this procedure? What did it accomplish?"

If injection is done of the aorta (regardless of the point of injection) and the purpose of the injection is to visualize and diagnosis the aorta itself, code 93544 is coded instead of 36200 as 93544 is specific to aortography DURING a cardiac catheter procedure. There are a few modifications to this code but we'll explain these next week.

When aortography is done during a heart cath with the soul intent to interpret the condition of the renal and/or iliac arteries, but doesn't actually place the catheter into these vessels and perform separate injection, we call these "drive-bys". I noticed Dr. Osis did these quite a bit but I did not see that he had coded for them on any of his claims. For Medicare claims only, I showed him these "drive-bys' were billable and were reported with G0275 for renal interpretation and G0278 for iliac interpretation. (Again he was very happy). I told him to be careful though, G0275 included a flush aortogram and therefore if only one injection was done of the aorta during a cardiac cath procedure ONLY G0275 could be coded. In order to code both G0275 and 93544 a separate injection of the Aortic Root would need to be done at the time of the abdominal aortography.

Each of the injection codes 93539-93545 is coded once per total operative session even if multiple injections are performed in one or more vessels. Remember, these codes report a physical injection into their specifically named site(s). If the catheter did not go there, don't code it.

The last piece of the puzzle is the "supervision and interpretation" or the "I spy" portion of the exam. This is another piece that is using separate equipment, the fluoroscopy machine. The images of the contrast dye are displayed on the fluoro monitor and from these the surgeon can determine the medical state of each of the cardiac vessels. There are only two codes for all the interpretation done for a heart cath. 93556 reports interpretation of injection done in any structure except the Atriums or Ventricles. 93555 is used to report injections of any number of the four chambers of the heart.

These codes are also only reported once regardless if multiple structures within the same code are injected or if multiple injections are done. Lastly they would need to have modifier -26 appended for the physicians' portion of the exam.

Dr. Osis appeared to have a much clearer understanding of how the cardiac catheter codes worked together to paint a perfect picture of exactly what he was doing. Armed with this information I showed him how the average catheter claim may look. We took an example from his pile, a Medicare patient where he performed a typical "left heart cath with injections of the coronary arteries, left ventricle, and aorta for exam of the renal arteries only. Pressures were taken from across the aortic valve and interpretation was performed. With this exam we had:

93510-26
93543
93545
93555-26
93556-26
G0275

Aortography code 93544 was not coded because the only thing we interpreted from this injection was the renals.

Time was calling and so was his wife, so we decided to end our conversation here in order to give him time to digest the information he gained. I told him I would be back next week to clear up his therapeutic interventions during cardiac cath. He thanked me for my time and went to take his call. I got to thinking about "digesting" and decided to head for the diner. I pulled the collar up on my trench coat, grabbed my coding hat and disappeared into the dark misty night.

Until next time Coding Sleuths!

--Tara

[top]

TeleWebinar Update

by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME President, CRN Continuing Education, Inc.

CRN Continuing Education, Inc.

For those of you that could not attend the Telewebinar on "2006 CPT Changes Overview", you missed a terrific class. Annette Grady gave a wonderful tutorial of what was changed and why. But if you missed the live class, it does not mean you missed it entirely. You can still purchase the recording for the low price of $139. You have the choice of immediate fulfillment with a downloaded recording, or if you want a CD, you can have one sent to you for an additional $10. Go to www.crnshoppe.com/tw and go to recorded events and click on for "2006 CPT Changes Overview" to order the recording. I learned a great deal from this class and I know that you will really get a lot from it as well.

Suzan Hvizdash is doing a MiniClass on "E&M Auditing: The Write Stuff!" We have been hearing that there is a lot of need for help in auditing, so Suzan has put together this 1.5 hour MiniClass for Wednesday, December 7, 2005 at 2pm Eastern Standard Time. Suzan is one of the Queens of E&M auditing and she is also a terrific teacher. She will take you through the basic nuts and bolts of auditing in this class. So, if you were looking for help in E&M auditing, don't miss out on this class.

Feedback has also told us that Diagnostic Radiology is a desired area for education. To that end, Tara Conklin, our very own Coding Sleuth will be providing a TeleWebinar entitled "Seeing Through Diagnostic Radiology" on Tuesday December 13, 2005 at 2pm Eastern Standard Time. So, if you are trying to get your eyes focused on your diagnostic radiology coding, make sure you don't miss this TeleWebinar either live, or if you can't be available on the 13th, you can always purchase the recording.

January 1st is almost upon us and the new Medicare Appeals Process will be implemented for Physicians practices as of the new year. You can still purchase the recording of the TeleWebinar, "The New Medicare Appeals Process as of 1/1/2006" (so many changes as of January 1st). You don't want to miss this boat, because one of the changes is a modification to the time period in which you have to appeal and to whom you appeal and when you can add information to the appeals process. Not knowing this critical information can cost you reimbursement which could be due you had you known the process!

Our mistake is your opportunity. There was a problem with recording Quin Buechner's wonderful class on Non Physician Practitioners. So, we will providing another opportunity for attendance of this TeleWebinar live on January 10, 2006 at 1pm Eastern Standard Time. At that time, the recording will be made, so that those who had ordered it in recorded format may receive the class. This gives others who may have been busy the first date, the opportunity to join the second date. Our mistake is your opportunity.

If you go to the TeleWebinar page, www.crnshoppe.com/tw you will see that we have scheduled a great deal more classes. Deb Grider will be presenting "ABN's in the Physician's Office" on Wednesday December 12th at 2pm Eastern Standard time. Robin Roach will be providing an excellent class for those billing companies in our community on "Marketing for the Independent Medical Biller" on Thursday 12/15/05 at 2pm EST. Although this is oriented towards Medical Billers, I am sure that independent consultants could learn a tidbit or two (or three) from Robin. I have heard Robin speak at the AMBA national conference (American Medical Billing Association) and I can tell you that she is a wonderful speaker and educator.

Our own Laureen Jandroep is going to present her true and tried method of educating E&M documentation on Wednesday 1/4/06 with her course "Locate your HEM in time! A Unique Approach to Understanding E&M Coding". This class is wonderful as it breaks down E&M into terms that almost anyone can understand, even your doctors. This is a class that you should try to get your doctors to sit in on, and if not, you should attend and then use Laureen's method to educate your physician. It also will be great for educating your entire staff. Remember you just need to dial in once, purchase it once and have everyone around a phone (and a computer if you want, but you don't have to have a computer; it can be done audio only) and educate everyone for $139. Or you can purchase the recording and have it to train the staff over and over again with the recording, including your physicians.

And finally, the last course we have scheduled at this time, Suzan Hvizdash will be speaking on "Auditor Training Workshop: Learn How to Educate Physicians, Their Staff and Your Peers". This class will be held on 2/1/06 at 2pm ET.

We are working on other terrific classes for Neurology, Fee Schedule Establishment, Compliance, Otolaryngology, Orthopaedics, Neurosurgery, and many other terrific topics. Email me at b.cobuzzi@att.net if you have any particular topics that you would like covered. Remember that you can purchase any of these classes recorded if you cannot attend them live.

Any time you want to check out the calendar of events, you only need to go to www.crnshoppe.com/tw or when you are on the CRN site (anywhere), click on CEU's on the top and then look at the second row of menus from the top and click on Menu.

We have commitments from many speakers and we are excited as the calendar fills up. Get the word out to your colleagues about this great opportunity for education that can be used for compliance and CEU's. We provide CEU's from the AAPC and AMBA. We will be getting approval soon to provide CEU's from HCR (Healthcare Compliance Resources). Stay tuned, this is just getting bigger and better and we are very excited to be bringing it to you.

Remember, all you need is a phone to participate. Optionally, you can be on the Internet and watch the show as the presenter advances their slides - just as if you were at a live event. This is also what the recorded version of the TeleWebinars will be like should you not be able to attend live but want the content. You will earn CEU credit either way. Click here to check it out.

Upcoming Live Events:

	12/7/05 E&M Auditing: The Write Stuff! by Suzan Hvizdash, CPC, CPC-PC
	12/13/05 Seeing Through Diagnostic Radiology by Tara Conklin, CPC
	12/14/05 ABNs in the Physician's office by Deb Grider, CPC, CPC-H, CPC-P, CCS-P, CCP
	12/15/05 Marketing For the Independent Medical Biller Robin Roach, CMRS, President Health Data Solutions, Inc.
	1/4/06 Locate Your HEM in Time! A Unique Approach to Understanding E&M Coding by Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS
	1/10/06 Coding & Billing Your NPP Services by Quinten A. Buechner, M.S., M.Div., ACS-FP/GI/PEDS, C.P.C. President, ProActive Consultants, LLC
	To Be Announced Orthopaedic Arthroscopic Surgical Coding Annette Grady, CPC, CPC-H
	2/1/06 Auditor Training Workshop: Learn How To Educate Physicians, Their Staff and Your Peers by Suzan Hvizdash, CPC, CPC-PC

Upcoming Speakers - Dates to be set

• Marvel Hammer
• Frank Cohen
• Pam Biffle
• Nancy Reading
• Caral Edelberg
• Terry Leone
• Linda Martien
• Peggy Pugh
• Betty Johnson
• Terrance Johnson
• Brenda Chidester

Interested in becoming a speaker? E-mail me.

Join our CEU Notification List to be notified when new topics are added.

Join us on CRN CE as we experience the future of coding, compliance, billing and reimbursement education. Go to http://www.CRNShoppe.com/tw to purchase your TeleWebinars. Go to http://www.CRN-CE.com to explore the CRN Continuing Education site. Have a great 2 weeks until we chat again! 

--Barbara

[top]

Institute News

by Pam Biffle, CPC CRN Coach

Do you have a CRN Institute Student Success Story to share? Just drop an e-mail to Pam. Let us know about your promotions, new jobs and new credentials or anything else you would like to share!

If you need college credit E-mail Laureen about how to enroll at Drexel University even if you don't live anywhere near Philadelphia.

New classes are being formed for January at Christina Healthcare in Delaware.
E-mail Laureen if you are interested in joining this group.

For those working full time in NJ the CRN Institute is forming a consortium where employers can take advantage of a grant program that provides training funds (including books and possibly the board exam fees) to provide their employees added skills. The employer contributes the paid time for the employee to attend the training. For more information and to be put on the interested list E-mail Laureen.

Most of you are aware that we offer courses in Medical Billing, Physician Coding and Hospital coding but were you aware that we also offer courses in Pathophysiology and Pharmacology self study courses for only $199.00 each. Check back as we announce new courses now under development. Let us know what new courses you would like to see the CRN Institute offer.

Don't forget we offer payment plans of $195.00 down and $100.00 a month.

Student Success Stories

Name: Kathy Burns, CPC

Employer: Dr. Mark S. Ross

Job title: Office Manager / Coder

What made you decide to take a course?: I have been with my doc. podiatric surgeon, for 21 years now. It was time for me to go in another direction and open up other options. I am not sure what I plan to do with my certification right now but it feels good to have accomplished what I have.

Why did you pick CRN Institute?: I stumbled across CRN on line. After some research, it was what I was looking for. I had originally attempted to prepare myself through books I had bought but CRN had such a great program I was confident that was the way to go.

What did you like best about the course?: The course was easy to follow. Very informative and help was always available if I needed it. It was excellent preparation for the board exam. I also liked the immediate results from the exams in each module. I knew exactly what I needed to focus more of my time on.

What did you like least about the course?: Those darn mock board exam questions!

Is there anything you would say to someone thinking about taking a course?: I would certainly send them to CRN.

Are you planning on sitting for a Board exam?: I did, 11/18/05 and just received my results. I passed!

Which exam?: CPC

Do you currently have any coding/medical credentials?: PMAC, CPC

Any other comments?: Thank you CRN!

--Pam

[top]

CRN Member Highlight

Erica Schwalm retesting for CPC

Where are you from?
Western Massachusetts

What is your favorite activity?
Having fun with family and friends.

Do you have any hobbies?
Learning new things, going to the ocean/lighthouses, boating, fishing, camping, & scrapbooking.

What credentials do you hold?
Welll. if I wasn't such a procrastinator I would still be a CPC. I didn't turn in my CEUs this year so I will be re-taking the test in February. Yeah, yeah.. I know!

What organizations do you belong to and how have they helped your career?
I am a member of the AAPC. Attending the local chapter meetings is a great way to network with other coders in the area and learn new things. I am also on the curriculum advisory board at a local college that teaches billing and coding.

How did you get into the field of medical billing and coding?
I got an entry-level billing job after taking medical secretary courses. I learned coding on the job and fell in love with it. From there I continued to learn and move up.

What is your current position?
It's funny you ask that. I work for an awesome multi-specialty physician billing company. I was the Coding Supervisor, then the company created a new position they offered me which I will be starting in the next few weeks. We haven't quite figured out the title yet! Maybe "Quality Analyst". I'll be doing a little of everything - auditing, QA checks on various departments, analyzing denial trends, appeals, etc. etc.

What is one of your accomplishments in this field that you are most proud of?
I fought MassHealth (Medicaid) and won. I was working for a sports medicine group and MassHealth denied all of our Nucleoplasties, even though it was on their list of covered codes. I knew I was right so I just wouldn't give up. I wrote letters and called until they finally agreed. It took about two years, but I eventually was able to go to Boston to plead our case. . It was awesome. One of the doctors came with me and a rep (from Arthrocare I think it was) also flew out. They ended up paying the claims.

What do you find most exciting about this field?
It's challenging and satisfying - figuring out that tough surgery or winning that major insurance appeal. It's interesting and there are so many opportunities to learn something new. It's fast-paced and keeps you on your toes; things are always changing. There are lots of career choices.

What do you find most frustrating?
The inconsistencies and the denials. It can get frustrating when you try to follow all the rules by coding correctly per CPT, CMS and CCI guidelines, - and the insurance company denies because they have their own guidelines, which most of them don't bother making public. There are so many different plans that it's almost impossible to remember everything you need to remember. For this insurance you need this modifier, but for this one you don't. This one covers this procedure, but this insurance will only pay for this specific diagnosis. It is so complicated that denials are inevitable. It's even more frustrating when the insurance is wrong and they won't budge. Some of them make you jump through hoops to get a claim reprocessed.

What do you feel the future holds for this field?
I think it's going to be the way it has been - constant change. We will have to continue to adapt to our changing roles. With every new law and technologic advance, we will learn, adapt, and try to perfect a process that will never be perfected!

What would you tell someone just starting out in this field?
Don't be afraid to take chances, don't be afraid to question things, go above and beyond your job duties, and don't work at a place that makes you unhappy! Also, continuing education is a must. It doesn't have to be costly. There are plenty of free resources and networking opportunities out there, you just have to be willing to invest the time looking. And of course, be flexible and adapt to change!

If there was one thing you could change about this field what would it be?
I wish more providers would get involved with the billing & coding process. I feel like some providers are not interested enough in coding correctly or fighting denials.

Who do you consider a mentor?
I don't think I could name just one person. There are so many people who have helped me and taught me things.

What is your favorite billing or coding product?
Ingenix's Coders Desk Reference for Procedures.

What is your affiliation with the CRN and how has that helped you?
I am a member and participate in the list as often as I can. I can't even stress enough how beneficial the list has been. There are so many smart people who are willing to share their time and knowledge to help others. I have learned so much from reading the posts and asking questions. Thank you!

Provide any contact information you are comfortable with: Erica can be reached at. EricaDSchwalm@aol.com

[top]

Humor

Joke:
Knock knock.
Who's there.
HIPPA.
HIPPA who?
I can't tell ya.
Submitted by Linda H. from Texas.

Joke:
Question: What is the difference between God and a surgeon?
Answer: God knows He's not a surgeon.
Submitted by Tracey McEntee.

Thanks for your joke submissions! Keep 'em coming!
Submit your joke or cartoon here and be entered in a drawing for a free TeleWebinar of your choice!

[top]

Dear Cody

Dear Cody,
Greetings! I code for an ASC in New Jersey. For arthroscopic chondroplasty of the knee (performed with another knee surgery, such as 29881), can we report/bill G0289? If this code for physicians only or can ASCs report and bill this code? THANKS FOR YOUR ASSISTANCE!!! I APPRECIATE IT!
--RP

Dear RP,
Code G0289 is only for physicians and not allowed to be billed by ASC's. It is not even on the Medicare ASC listing. For chondroplasties performed in separate compartments at the same time as another arthroscopic knee surgery, unfortunately, for facilities they are bundled and there is no way to separate it out. Bummer deal I know, but if you look at it another way, there really isn't any additional cost on the ASC side for this. Sometimes they may use a wand that they weren't already using for another surgery, but still even then the costs are minimal.
--Cody

You can submit your question to Dear Cody and perhaps you will see advice from Dear Cody in a future newsletter.

[top]

What's new, exciting, and popular at CRN can be delivered to you automatically via . CRN provides news and information via a news syndication format called RSS (Really Simple Syndication)! RSS is designed for syndicating news, the content of news-like sites, personal web logs etc. Receive the latest RSS headlines to your desktop or browser and then just simply click on the links to read the articles. An RSS reader (i.e. Pluck) is required to read these articles and many of them are free to download. For more information and other free RSS reader downloads, please visit http://www.npr.org/rss/index.html. To subscribe to any or all of CRN 's RSS feeds please visit http://codingandreimbursement.net/forums/rss.php.

The CRN respects your time. We sincerely feel that this newsletter will be of interest to you. If you want to change your e-mail address or opt-out of this list click on one of the links below.

Opt-Out Newsletter List - to notify us to stop sending newsletter click here.
Change E-Mail - to notify us to update your email address click here.
Add E-Mail - to request we add another email click here.
Join Discussion List - if you want to join the CRN-L and/or the CRN Web Forums or if you want to update your information on file with us click here.
Join Newsletter List - if this was forwarded to you and you want to be on the list that receives this newsletter click here.

If you want to continue receiving these e-mails and you don't want it filtered out of your inbox as "bulk e-mail" or "spam" then please add newsletter@crn-online.org to your address book.