Coding & Reimbursement Network News

From the Founder

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

From the Founder

Since I was not able to attend the recent AAPC confence I have asked Suzan Hvizdash to step in and let you know how things went at the CRN booth.

“The Spirit of Coding”: AAPC National Conference 4/3-5/2006
see photos on the right >>>>>>>>>>>>>>>>>>>>>

Spirit was definitely a great choice of words when describing this year's National Conference.

The St. Louis local chapter made everyone feel so welcomed and provided a fantastic hospitality room offering siteseeing options, coupons to attractions, stores, and restaurants, and just a general feeling of friendliness.

The conference kicked off Sunday and went running right from the start. The Executive Board of the National Advisory Board, led by our President, Cindy Parman, did a nice presentation on the Spirit of Coding, with the pieces of the puzzle: Networking, Education, Commitment, Communication, Professionalism and Leadership. We all participated in some very enthusiastic specialty networking sessions that evening. The conference was then in full swing early Monday morning. We learned 50 ways to help your career with Marcella Bucknam and that really helped us all get going to our first classes. Our beloved Barbara Cobuzzi stood in for Laureen and didn’t skip a beat in offering back-to-back Modifier sessions that were very well received with e-mailed questions coming to her even before the end of Conference!! We enjoyed lunch and a reception with the vendors on Monday as well. Many folks stopped by the CRN booth where we chatted and networked showing off all the wonderful features and people that make up the CRN (and that includes everyone reading this newsletter).

Tuesday again started with great Spirit with Georgette Gustin encouraging all to the “Catch the Spirit.” We then broke into the morning’s sessions that were all very well attended and highly informative. I enjoyed Dr. Todd Husty’s session on the communication between the coders and the physicians. The title of my presentation was, “Extenders as Co-Pilots.” And thanks to my good friends John Verhovshek, Rebecca Burgess, and Debbie Moriarty, it was hopefully very entertaining as well as informative. Barbara Cobuzzi, Joan Gihooly, and Katherine Able presented a well received panel on Tips of the Trade, for reimbursement. Their main problem was running out of time; so much to say for three such people and there was no time for questions. The other afternoon sessions didn’t lose any steam and were all packed with great information.

The awards banquet that night was great fun and certainly filled with a lot of Spirit. Our very own Pam Biffle was selected as “Networker of the Year” and I was appointed to the National Advisory Board. Rhonda Buckholtz, also a long time CRN member was also appointed to the National Advisory Board. The AMA sponsored the awards banquet and Michael Bebe of the AMA gave an interesting talk on how new CPT codes are created. We all had a terrific time dancing the night away. (Of course we also had our regular meetings in the hotel bar for very important sessions!).

Wednesday was packed with three additional sessions. Many of us attended Dr. Steven Levinson’s breakout session on Practical E/M Solutions for Quality Patient Care, as well as Jo Ann Baker’s very informative session on Monitoring Observation Services for facilities. Another set of break out sessions in the late afternoon included Sheri Bernard’s, Ophthalmology Dissection of the Cow’s Eyes, and E/M Evolution and Direction given by Bill Dacey; both high powered and informative sessions. Not to discount any of the other sessions; the feedback that I’ve personally heard was that all the sessions this year were terrific and very informative.

The Seattle kick off was a really “fishy” experience. We got to see the Pier Fisherman throwing fish back and forth and Annette Grady successfully caught one! I’m sure that’s something she won’t quickly forget!

Now, we’re all back to the daily grind, anxiously waiting for next April when we get to hit Seattle. (I’ll be wearing black and gold a lot that week-sorry, Steeler fan on board!).

TIP from CRNCodingToday.com:
Many sections of the CPT book have section notes. These notes tell you special coding instructions for a series of codes. CRNCodingToday now has those notes available for you. Whenever you look up a code, check the top of the screen for the list of words in blue. Each of these words is linked to a specific section of the CPT book.

POINT>CLICK>CODE to view CPT section notes. Get it right! Use CRNCodingToday! It is fast! It is easy! It is correct!

Until next time!

--Laureen = )

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by Suzan Hvizdash, CPC CRN Senior Auditor, Instructor

Well, conference is over and we’re back in full swing. The list was still quite active in the absence of a lot of Listers.

Conference was great! Fantastic speakers (including many of us - Barbara, Katherine Abe , Jo Ann Baker, Joan Gihooly, and myself just for starters.

However, the list goes on…

Questions were of a wide variety over the last few weeks. We answered questions concerning borderline diabetes (790.29), SI joint Injections w/o fluoroscopy, scar revision of the chin. We also had a brief discussion on adding a “No Perfume” sign in the waiting room for our patients.

There was question concerning billing of OB charges when the patient hadn’t always had surgery. To see the full question and follow the thread you can click on http://health.groups.yahoo.com/group/CRN-L/message/52357. Briefly though, the lister mentioned several tests and services done by the practice and how they wanted to bill for the antepartum care and delivery only and would this be the best approach. The answers seemed to indicate that the bill was correct and the urinalyses that were done might need to be appealed to the insurance company.

What about patient identity theft. This was certainly an interesting thread. Apparently a patient did not use the correct name when checking in. The insurance company informed them of this and now want a refund. It seems that the patient and the insured switched information in order to obtain medical care. The patient was a friend of the insured’s. Another instance was where the patient had stolen her sister’s identify. What do you do to avoid this type of thing? One office mentioned they take pictures of all their patients. To see some of this thread take a look at http://health.groups.yahoo.com/group/CRN-L/message/52410.

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

Until next time,

--Suzan

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The Coding Sleuth

by Tara Conklin, CPC

The Mystery of the Maddening Modifiers - Part I

Merriam - Webster’s Dictionary defines the word “modifier” as a word or phrase that makes specific the meaning of another word or phrase. To show longevity of this definition Webster’s Dictionary of 1828 defines “modifier” as “He or that which modifies”. It’s safe to say the word hasn’t changed much since its inception.

When applying this to the medical coding world we do have to change it (or for lack of a better word, modify it) to apply to “numbers” because, well, that’s what we have … number modifiers.

There are many modifiers to choose from too. Some, the most commonly used (and widely accepted) are listed on the front cover of our CPT manuals, (nope, open it up and look on the inside.. see they’re right there). Others are listed on the front and back covers or the HCPSC manual. These are their own animal all together and we’ll deal with those another time. What we want to look at is the CPT modifiers since we use them all the time and as we all know they can be quite confusing.

• When are they appropriate?
• How do you use them?
• What order do you put them in when you need more than one?
• What’s the difference between them?

For some coders these answers are clear as crystal. But for many others these are complex questions. So why don’t we put on our sleuthing caps and unmask the mystery of the maddening modifiers?

The proper understanding is important to both coder and biller alike. Why you ask? Simple. If the coder doesn’t know how to use them and in what application, they might not file their codes correctly, or paint a clear picture of the services performed. Likewise, when a biller gets a denial, or even a payment of a claim without understanding the modifiers, they may not understand the reason for denial or even if a payment received was correct based on the modifiers billed. All too often I’ve seen billers accept the allowed amount payment, write off the remaining balance (because that’s what the EOB told them to do) and not realize the procedure was billed bilaterally and the insurance company only paid for one side. Trust me - they do this purposefully, counting on the fact that most billers won’t catch their… ehem… error. We all know the insurance companies like to play games with our claims. If we are going to beat them at their own game we all need to wisen up.

In order to simplify our understanding we will group modifiers by what services they apply to. In this issue of the Coding Sleuth we will concentrate on E&M modifiers. Something to keep in mind when dealing with many modifiers is they are usually added to a charge that is being bundled (or normally included) in another service on the same day. Remember, modifiers paint a clear picture of what services were performed and under what circumstances.

The Office Encounter

There are several modifiers that get tacked on to the E&M codes when the services provided deem their use necessary. Remember all of these modifiers get applied to E&M codes only, never procedure codes.

-25 The most common ones we use are what I like to call our “pre-procedure” modifiers.

M-25 reports “a significant, separately identifiable Evaluation and Management Service by the Same Physicians on the Same Day of the procedure or other service.”

This has two meanings, really. The first applies when the physician has performed the necessary components required to bill and E&M (history, exam and medical decision making) in addition to other services in which the E&M would normally be considered part of. It doesn’t necessarily apply only to procedures but under some circumstances two E&M services may be performed on the same day for unrelated reason, “unrelated” being the key word here. Say a patient has an office visit in the morning for a checkup on their diabetes. The physician bills the appropriate E&M for an established patient. However, later in that day the same patient goes to the ER complaining of chest pain and the same physician admits them. He will also bill an admit code but in order for both E&M services on the same day to get paid and be established as valid services, modifier 25 would need to be appended to the admit code. This is also applicable when both E&M and critical care are performed on the same day.

The most common use of modifier -25 occurs when a valid E&M and a procedure are both done on the same day, and sometimes within 24 hours of each other depending on the circumstances. 25 is also used as a “decision for surgery” but for minor procedures. What constitutes a minor procedure? Well, technically anything that carries a global period of less than 10 days, including those without a global period. The reason for this distinction is modifier 57, which we will talk about in a minute applies to major procedures and in most procedures the “preoperative” evaluation workup is included in the procedure. For an E&M to be separately billable on the same day as a procedure we need to show the physician needed to take a history of the problem, examine the patient and finally decide to perform the procedure on the same day. The decision for surgery was made, but in this case the procedure was minor for all accounts.

-57 We mentioned modifier 57 a moment ago is used to report an E&M service on the same day as a major procedure when the E&M service resulted in the physicians’ decision to perform the actual procedure. As opposed to minor procedures which carry a pre and post operative period of 10 days or less, a major procedure is one which carries a pre and postoperative period of 11 days or more; 90 days is the norm. The tricky thing is the global periods we are all familiar with are only laid out in the Correct Coding Initiative (CCI) which only applies to Medicare claims. The trouble arises when private payers require these modifiers to accept a claim, but turn around and don’t follow the CCI guidelines. Yes, my friend, this is what we call a “double standard” and the big insurers live by them… or more appropriately bank on them.

Now that we have acquainted ourselves with two modifiers used before a procedure is done let’s take a look at a few we might encounter during the postoperative period.

-24 We know procedures that carry a global period normally have either 10 or 90 days after the procedure in which all “normal and related care” is included in the price of the procedure and not billable separately. During this time period the patient may visit the same physician for a service unrelated to the procedure. The physicians may need to indicate the E&M provided was not related to the procedure and therefore separately billable. He easily accomplishes this by appending modifier -24 “unrelated E&M service by the same physicians during a postoperative period.”

Now, as we know it is very common for the patient to come in for a scheduled follow-up visit and while they have the undivided attention of their physician, they bring up some new complaint. Or perhaps the physician may care for something else during the same encounter. Don’t let this confuse you. First, don’t miscount the time and effort he put forth following up on the unrelated problem and just throw the baby out with bathwater (don’t chock the whole visit up as non-billable simply because it was scheduled as a global follow-up). He performed two distinct services during this encounter, both of which should be clearly explained on the claim form and most importantly in the documentation. Get your physicians in the habit of making clear demarcation points in his dictation or the medical record when performing different services on the same day, especially E&M. When applicable, the three key components (history, exam and medical decision making) should be clearly defined for each billable E&M code.

In the instance where you have both a global postoperative visit on the same day as an unrelated E&M service, both procedures should be billed on the claim form. 99024 with a 0 charge is used to report the follow-up visit, and the appropriate E&M code for the unrelated care is reported with modifier 24. A key piece of this puzzle is to make sure you apply the appropriate diagnosis codes to each service. Without a clear linkage between diagnosis and service, you can be sure a denial is coming down the pike.

Since these are the three modifiers that apply to evaluation and management services, and to avoid this article turning a newsletter into a short novel, we’ll only cover these three modifiers here.

There is, however, one important aspect of these three modifiers to take note of. Notice in the descriptors of each modifier they state “by the SAME physician…” The reason these apply to the same physician performing a service either on the same day as another or during a global period, is because the rules governing the procedures or services only apply to the same physicians. For example, if another physician performs the surgery on the same day as the first physician made the decision for the procedure, then there is no coding conflict. The CCI edits and these modifiers cancel each other out. They simply aren’t needed. Both physicians are billing their own separate service. You will see this apply with other modifiers we will be talking about in future issues.

Lastly, keep in mind, all physicians working under the same Tax ID in the same group or specialty fall under the umbrella of these modifiers. If Doctor A performs the procedure but his partner Doctor B performs an unrelated service during the postoperative period, Doctor B would need to append the appropriate modifier mentioned in this article to his service.

Coders and Billers alike should be educated and knowledgeable on coding and modifiers. Coders need to submit a clean claim and billers need to understand what they are looking at when reading EOBs and be able to discern if payment or denial is valid based on the codes and the modifiers billed. Insurance companies take great pleasure in twisting and even changing the codes we bill to suit their needs. Unless coding and billing personnel are rowing the same boat, inevitably the insurance companies will quite easily plunder away the physician's hard earned dollars.

Until next time, Knowledge is Power!

--Tara

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TeleWebinar Update

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

WOW, the AAPC National Confrence was terrific. I just got home after spending a week in St. Louis. The Networking and educational opportunities were great. I got to see old friends and make new ones. I got to teach and learn new things. We had a CRN booth in the exhibit hall and got to see CRN members (nice to be face to face ) and got to sign up lots of new members. We are excited about all the new people joining the CRN Community.

I also got to meet with some very good Subject Matter Experts (SMEs) and they are excited about recording Contining Education Telewebinars for CRN CE. So stay tuned for some more interesting, dynamic and needed classes on the CRN CE site. In the meantime, check out the terrific classes currently available as you need CEUs, compliance education or just want to learn some very interesting stuff. Barbara J. Cobuzzi, MBA, CPC, CPC-H President CRN Healthcare Solutions www.HealthcareSolutions.com b.cobuzzi@att.net

We have started a new “arm” of the CRN organization, CRN Continuing Education, to bring quality telewebinars to the coding, compliance, reimbursement and billing market at a very reasonable cost. We have been growing since our start in September and have been attracting some of the best speakers and educators in the country to the CRN CE family. I am very excited as we grow our portfolio of offerings. I have been busy getting new classes planned and recorded. Currently, I am off to a well-earned vacation and then some work involving travel. So, I will restart recording new classes in May, and we will continue adding new courses for your development, training and education.

We recorded Patricia (Pati) Trites of Healthcare Compliance Resources when she did three courses the week of March 13th for CRN CE.

First, Pati taught Employee Overtime-Is Your Practice At Compliance Risk? Many physician practices underestimate the risk involved in making a mistake in administering the wage/hour laws. One of the most common mistakes made is improperly classifying certain employees as exempt from the wage and hour laws and not paying overtime when it is required. What about work time while traveling and the overtime considerations. This has not only great impact on the practice’s operations, but on their compliance program. One of the key elements of a compliance program is your employee policy manual. Come listen to Pati speak on this very timely topic. She recorded this class on 3/14/06 and it is available now for download on the CRNShoppe at TW_EmpOtCompliance. I have the wonderful opportunity of listening to all of these classes when they are being recorded and I have to tell you that it was extremely informative and of a lot of use for a practice. Not only did Pati address overtime rules, but she also touched on issues such as employees versus independent contractors and how to determine if an employee qualifies for an independent contractor. As we have more and more employees telecommute, these are important issues to grapple with and address to make sure your organization is within compliance of federal and/or state guidelines. Pati provided the information and tools to evaluate the employee and the appropriate status under which they should be paid. The practice’s employee manual and handbook is an integral and key aspect of the practice’s compliance program, and thus, this is important in making sure your business is in compliance with employment laws. If you have not started your compliance program, starting here will be starting your compliance program with your compliance program.

The second class that Pati Trites recorded was; Mandatory Compliance Programs Have Arrived. The Deficit Reduction Act of 2005 has made it mandatory to have a fraud and abuse compliance program by Jan 1, 2007. This applies to all entities that pay or receive at least $5 million in Medicaid funds. Are you ready? Find out how to comply with the law. Even if you are not a large practice, there are a lot of small things you can do to start your compliance pathway. Pati provides many practical tools for you as you either are starting to plan a new compliance program or you are reviewing your existing compliance program. This continues to be a very timely topic. This is about how do you get started and stay on track with your compliance activities; how to not have them overwhelm you, and how do they fit into your daily activities. Compliance is not just for the big operations and you can do it. This course is available on the CRN Shoppe to purchase the recording at TW_Compliance.

Pati’s third class is near and dear to my heart. The class, Evaluating EMR/EHR Systems for Compliance? addresses an area of EMR/EHR evaluation that seems to be overlooked in many system reviews. This is so important as the more we travel down the HIPAA security road and as automatic encoders become more prevalent, there will be more and more pressure on practices to prove that their electronic systems comply with certain audit and compliance issues. These systems are very expensive and their implementation is often a very rocky road. A practice cannot afford to take this lightly and not consider the compliance related issues when evaluating these systems. This recording is available on the CRN Shoppe for purchase at TW_EMR-EHR.

Last, but definitely not least, Deb Grider is doing another minicourse for CRN CE on Coding Consulting 101. I have seen the slides and it is a terrific class. A lot of us are aware of the confusion that surrounds the “clarification” that CMS created when they updated section 30.6.10 of the Claims Processing Manual (Chapter 29), and a lot of concern exists on how we operate within the parameters that CMS has placed on the physicians, the practices and the coders. Deb addresses the AMA definition of Consultations as well as the CMS Guidelines as defined and clarified in Chapter 29 of the Claims Processing Manual (section 30.6.10). Deb brings clarity where there was fog and has some great suggestions for systems and procedures in the practice. She also has suggestions for you to bring back to your physicians on how they document the requests for consultations when they are truly requests for opinions. Deb has audited many charts, in and outpatient and it is through that experience that she can bring understanding to this topic, as well as practical operating advice. This class will be recorded just before the AAPC National Conference. It will, therefore, will be available just after conference, around 4/1/06. To order this minicourse, go to TW_ConsultationCoding101.

We have some other classes lined up for May as well. I received a few emails requesting classes on Neurosurgery. So, Voila, Eric Sandhusen is developing a two-part mini course series on Neurosurgery, part 1 on the spine and part II on the brain. We have also been requested to develop something on ASC’s. I have not started on that one, but I promise I will find the appropriate Subject Matter Expert (SME) for that topic. The point here is that a few people have emailed me with their needs and we have been able to be responsive with finding the right SME’s for those topics and got them scheduled. So, do not be afraid to email me at b.cobuzzi@att.net with our needs and I will look into whether we can get your needed topics scheduled.

Do not forget to look on the CRN CE web site at www.crnshoppe.com/tw and see all the classes that are already there available for purchase. There are a few on auditing, on appeals, on modifiers, on E&M, on radiology, on marketing the independent billing company, on non-physician practitioners and more. Go to the web site and see our ever-growing library of continuing education and CEU opportunities. Put a group around the phone (and if you want, a computer, but it is not necessary) and you all can listen to the class together for one fee of $139. What better, cost effective way do you have to educate your office? This is about having great teachers and timely topics that are worth the time and effort to listen and learn!

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, AMBA and 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 Events:

	Employee Overtime-Is Your Practice At Compliance Risk? Patricia A. Trites, MPA, CHBC, CPC, EMS, CHCC, CHCO, CHP
	Mandatory Compliance Programs Have Arrived Patricia A. Trites, MPA, CHBC, CPC, EMS, CHCC, CHCO, CHP
	Evaluating EMR/EHR Systems for Compliance? Patricia A. Trites, MPA, CHBC, CPC, EMS, CHCC, CHCO, CHP
	Consultation Coding 101 Deborah Grider, CPC, CPC-H, CPC-P, CCS-P, EMS

Upcoming Speakers - Dates to be set

• Marvel Hammer
• Frank Cohen
• Pam Biffle
• Nancy Reading
• Caral Edelberg
• Terry Leone
• Linda Martien
• 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

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Institute News

by Pam Biffle, CPC CRN Coach

CRN Institute News

Do you have a CRN Institute Student Success Story to share? Just drop an e-mail to pam@crn-institute.com. 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 start April 1, 2006.

For those of you who will be attending the AAPC meeting in St. Louis the first week of April be sure to come to the CRN booth to say hello. I’m looking forward to being able to see you in person.

Classes are also held 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 self-study courses in Pathophysiology and Pharmacology 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 $195.00 down and $100.00 a month.

Student Success Stories

Congratulations to Susan Cafaro who is the Office Manager for Dr. Tully and Dr. Napierala, Ph.D.. Susan recently completed the 301 Physician Coding Course.

What made you decide to take a course? My friend, Gina Nuske, told me about the course and I wanted to further my career by taking the course.

Why did you pick CRN Institute? I liked that you could take work at your own pace throughout the course.

Is there anything you would say to someone thinking about taking a course? I feel this course was very informative and would suggest anyone interested in coding, take this course.

Do you currently have any coding/medical credentials? No coding credentials yet. I have been in the medical field for the past 15 years and doing some coding in my jobs.

Are you planning on sitting for a Board exam? Susan is planning on sitting for the CPC exam April 22nd in Canton, Ohio at Mercy Hospital. We look forward to reporting her success.

Any other comments? I want to thank you very much for all the help when I would have to call you. If you were not available you got right back to me as soon as possible.

If you are a CRN student and have recently gotten a new credential, job or have something exciting you want to share send it to me so you can be featured in our next issue.

Until next time...

--Pam

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CRN Member Highlight

Tara L. Conklin , CPC

Where are you from?
Born and raised in Colorado, but have been a bit of a nomad since I left home at 19.

What is your favorite activity?
Watching movies and reading.

Do you have any hobbies?
Scrapbooking, painting/drawing and writing.

What credentials do you hold?
CPC

What organizations do you belong to and how have they helped your career?
The AAPC has helped my career by providing the added edge to gaining a step or two on the Lateral Coding Ladder. It doesn’t automatically come with respect; that is something you have to earn no matter who you are. But a coding certification is usually the first thing a potential employer or client looks for when turning to someone for coding assistance. Having my CPC has allowed me to get my foot in the door with several employers that otherwise may not have considered me at all. Once I got in the door it was up to me to prove my worth and do the best job I can.

How did you get into the field of medical billing and coding?
After I had my youngest son, I wanted to get a job working at home. I originally turned to transcription as my older sister had successfully been transcribing from home for years. So having absolutely no prior medical knowledge I enrolled in the only school in South Jersey that was offering a transcribing course at the time (2000). It ended up being a Medical Office Assistant course which provided a little piece of all aspects of working in a medical office. During the course the subject of “medical coding” really sparked my interest. Hmmm, there’s a code for each procedure and diagnosis and it’s the coder’s job to figure out which ones are correct? How intriguing. After school, I worked as a medical biller for awhile. It didn’t take long to realize I did not like fighting with insurance companies to pay for claims I didn’t know how to fight. That’s when I turned to Laureen Jandroep, a woman who owned a billing company not far from me, who had decided to begin offering a coding course. Ooo, that coding thing again. I jumped on it. I was one of five of her first students in her first coding class. She gave us all the knowledge and ammunition we needed to take the CPC board exam. I passed it on my first try. Since then it’s been straight up. Thanks Laureen!

What is your current position?
Radiology Coder for a Consulting Group in Largo Fl and provide Independent coding and consultation in multiple specialties.

What is one of your accomplishments in this field that you are most proud of?
In my many travels I ended up at an outpatient clinic in a small rural town in Georgia. I was the only certified coder to have ever been hired in the 70 years the clinic was in operation. Prior to my arrival the coding had been done by two employees who were “self-taught” coders. Within the first month I discovered multiple coding and documentation errors potentially putting the clinic in danger of a fraud audit. In a matter of three months I had discovered almost $2 million in yearly revenue being lost simply because of erroneous information and lack of education to the staff and physicians. I was able to correct the past 18 months worth of Medicare claims for our Cardiologists catheter and interventional surgeries and found over $15,000 in additional revenue. He was very grateful.

What do you find most exciting about this field?
Learning something new every day and being able to pass on what I have learned to other people. Also… being able to fight an insurance claim now and get it paid!

What do you find most frustrating?
What’s good for the goose doesn’t have to be good for the gander. Physicians have to adhere to the same rules and laws, but the insurance companies can make them up as they go along. On the flip side, coding, billing and documentation are the foundation for getting physicians paid but it’s not part of their education and many don’t get it or think they need it.

What do you feel the future holds for this field?
It’s up in the air. Coding will always be around in one way or another simply because people will always be getting sick and need a physician to take care for them. Coders are probably the most important person in a medical office/hospital. The more things change, the more I see our doctors, insurance companies and perhaps even our governments turning to coders to provide some stability and direction.

What would you tell someone just starting out in this field?
Accept the fact this field is constantly changing. Being able to adapt to those changes is a crucial part of becoming a great coder. Regardless of what part you play in the world of medicine things are always changing. I tell students and coders alike “If I ever get to the point where I think I know everything, or say “this is the way it’s always been done”, then it’s time for me to hang up my hat and call it a day.” Also, be willing to learn from anyone. In the six years I have been certified I have had students fresh out of school teach me new things. Likewise, I’ve taught seasoned coders with 20 years experience a thing or two. You never know where you’re going to find a valuable piece of information.

Who do you consider a mentor?
The people I consider mentors most likely don’t know they are. Stan Szelazek & Dr.Zielske have taught me almost everything I know about Interventional Radiology and I have never met either one of them. Debra Jones, for helping teach me to keep a business head about me when I want to shoot from the hip.

What is your favorite billing or coding product?
(We’re trying to link to products available on the CRN Shoppe http://www.crnshoppe.com)
CodeCorrect and the Interventional Radiology Users Guide by the SCVIR.

What is your affiliation with the CRN and how has that helped you?
I started out as a student and then became a remote instructor for the CRN -Institute Physicians Coding Course. Now I participate in several aspects of CRN , including this newsletter. I met Laureen 7 years ago before I knew what this was all about and before CRN was born. She’s been a wonderful mentor in her own right and a very dear friend!

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