From the Founder

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

We have a great issue for you today. Suzan Hvizdash gives us a wonderful update of what has been going on on the listserv in her Listserv Lately column. By the way, if you want to actually read the full posts but are not subscribed to the listserv you can do so by going to http://codingandreimbursement.net/forums/forumdisplay.php?f=180.

Tara Conklin, a.k.a. "The Coding Sleuth" continues her story about the "Maddening Modifiers" - one of my favorite topics as many of you know. Many have written to say how much they enjoy Tara's writing style and how she makes it fun. Keep those comments coming!

Barbara Cobuzzi gives us an update on what is going on on the TeleWebinar side of things, plus an appeal for us all to share our forms and documents that help us do our job better. She will then put them up on the CRN website for all to benefit from.

Pam Biffle provides us with another "Student Success Story" and some CRN Institute updates.

Mary Campbell, CPC, CCS-P from California is our member highlight this issue.

And of course we have our sponsors on the right hand side. Please show them you support the CRN by clicking on their logos to see what they have to offer.

Next weekend I'll be teaching a two-day review blitz in Pittsburgh with Suzan Hvizdash so I hope to have my new 2006 recordings done at that time. More on that in the next issue. Have a wonderful first half of May!

Until next time!

--Laureen = )

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by Suzan Hvizdash, CPC CRN Senior Auditor, Instructor

Now back into full swing, the list was a little livelier the past few weeks.

We had a lot of different “types” of discussions. All, as always, very informative! One thing that I’ve started doing more regularly, that I would recommend, is reading some of the posts that are totally unrelated to what you are currently doing. This is advantageous from many different angles. The first and most obvious one is you get to learn new things about unfamiliar topics. You also see what those in other areas are dealing with and the issues that are coming up for them. Second, the conversation may lead down a road to where you are familiar and can interject your thoughts on common issues. It’s really interesting what I’ve been picking up lately by watching the other conversations.

That said, I watched the familiar subject of E/M scoring through the thread headed NHIC Medicare Training. A poster had attended a training session that was very informative and wanted to share. From there we discussed the scoring sheets of the many carriers around the country. Many of us have seen the various score sheets that the carriers use and have also noticed how different they all are. Barbara posted on the CRN a MedLearn Matters site that is quite helpful. Here is the link to the Evaluation & Management Services Guide.

Other conversations included talk of Cord Blood Collection. It was suggested to use code 59899. Many commercial payers won’t pay for this, however, one poster indicated that ViaCord would pay $100 if the insurance company doesn’t. Very interesting!!

Can coblation instrumentation cost be recovered when billing a tonsillectomy? The tools are expensive, according to the poster, however, the insurance companies don’t usually cover the additional costs incurred by using this technique, which can be done either to shrink the tonsils or to remove them.

Other coding questions that came up over the last two weeks involved Williams Syndrome and the appropriate ICD-9 code (759.89) for that disease. Questions were also raised regarding the billing of Procrit ® , Consultations, Anesthesia and Pin Removal.

What about coding for contraceptive counseling? The code 99401 could be used, but you may want to check to see if the patient’s insurance covers such counseling, per one of the posters.

Amongst the posts we had a poster warn all contact lens wears about a recall of Bausch and Lomb ® products (We’re always looking out for each other!!).

And there was even talk of an insurance company's CEO salary that had been reported on television a few weeks ago.

We really do talk about a lot of interesting things. If you aren’t already reaping the benefits of the list, try it out!

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 Case of the Maddening Modifiers - Part II

In our last look at this case we examined modifiers pertaining to E&M services before and after a surgical procedure. How they are used depends on many different situations.

In our second look at these mystifying little numbers, we are going to look at how some of them are used when applied to procedures themselves. They try to be sneaky and confuse us, trick our minds. Information on them can be hard to come by and when found…well, can be expensive to say the least. Why is it coding information seems to come at such a high price these days? We'll just leave that discussion for another time.

Well, don’t I get off track? Getting back on track let’s look at some surgical modifiers.

There are modifiers for bilateral procedures, reduced procedures, discontinued procedures, modifiers for two surgeons, to a team of surgeons, repeat procedures and oh so many others. With so many to choose from, and with some appearing to be so similar, how can we even begin to make sense of them. Easy... start from the beginning. So grab your hat and hop on board.

Walking through their neighborhood can be scary but we’ll tread lightly and take our steps one at a time.

-22 This is the first nuisance we visit along our way, unusual procedural service. The purpose of this modifier is essentially to increase the payment allowed to the surgeon for performing work above and beyond what’s entailed in the actual procedure performed. Perhaps the physicians spend unusual amounts of time taking down adhesions, or opening the incision because the patient is morbidly obese; perhaps the patient required unusual amounts of blood. All of these things would support the addition of modifier -22 to the procedure. The key and moreover the requirement to using this modifier is impeccable documentation by the surgeon. Each detail of why the procedure was more complicated or more unusual should be clearly dictated in the report. This may include extra time, extenuating circumstances, whatever they may be. Also make sure you drop the claim to paper and send the operative report along with it. Medicare is requiring all claims to go over electronically initially, so in their cases you may need to submit the report along with an appeal if the electronic claims get denied on initial submission.

-50 Our next encounter is with bilateral procedures billed with modifier -50. This seems pretty straight forward. When the same procedure is performed on both left and right anatomical sides you bill one procedure code on one line with modifier -50 appended. Now you might have seen the same procedure code billed on two lines with -50 on the second, but what a claim like this is telling the insurance company is you have perhaps a third arm or maybe an eye. The third eye theory may be okay if you’re a Buddhist, but it’s not a physical third eye and it doesn’t work for surgical procedures.

-51 This is usually a pretty harmless modifier. It does normally reduce the payment of the second procedure, but the miraculous thing is that most insurance companies will reduce the second procedure with or without this modifier. How nice of them, don’t you think? Most of the time, it’s not even necessary to add -51 because insurance companies are so diligent in reducing payments when they know they should. So when should you use modifier -51? Basically, when you’re billing the same procedure code twice and it’s not for bilateral purposes, and it doesn’t bundle into itself. For example, two lesions are removed from different sites, however the code used to bill each of them is the same. In order to paint a clear picture on the claim that the procedure wasn’t bilateral and we’re not billing a duplicate code, we append -51 to show a “multiple procedure” was done. Of course you can append this code to any claim when you bill multiple procedures, but not when they bundle. We’ll talk about that modifier in a minute.

Our next two modifiers work closely as a team in order to cause the most confusion. They can both be perplexing indeed. Get them apart, however, and they become less intimidating.

-52 This is used for “reduced procedures”. So what just exactly constitutes a reduced procedure? Did the surgeon decide to go get a low fat Tai Chi Latte somewhere in the middle of a splenic flexure take-down and the lysis of adhesions? Well… maybe. Sometimes during the course of a procedure circumstances may arise that prevent the operating physician from completing the procedure. A blockage in the transverse colon may prohibit the physician from advancing the colonoscope all the way to the cecum for a complete colonoscopy. Extensive arterial blockage might prevent a complete transcatheter thrombectomy and the surgeon decides to schedule an open procedure. Any number of variables can present themselves from performing the complete scope of a procedure. It’s in cases where these variables occur when modifier -52 is used. There are two important factors to remember when determining if -52 is applicable to a certain scenario. The first is to understand this modifier applies when the procedure can not be completed due to some constraint, our blockage for example. Do not apply this modifier when the procedure has to be stopped due to some aspect that causes distress to the patient, such as sudden respiratory arrest, or hypotension. This falls under our next modifier. Patience… be patient we’ll get to that shortly. Secondly, when a particular procedure was scheduled but was discontinued under these circumstances, the original procedure is billed with modifier -52 appended in lieu of a lesser procedure, even if one exists that completely describes the work done. You have to paint a clear picture of what was scheduled vs. what was done. Billing the originally planned procedure code with the proper modifier accomplishes this goal.

-53 The partner in crime to modifier -52 is -53. The difference between these two modifiers is as mentioned above. This is used when the procedure has to be terminated due to extenuating circumstance that, as CPT so eloquently puts is “threatens the wellbeing of the patient”. (check Appendix A… it’s Ragu… it’s in there). This would fall under our example listed above, such as sudden respiratory arrest, sudden drop in blood pressure or vitals. The proper billing of the procedure is still the same as in modifier -52 (bill the CPT code for the procedure scheduled and append -53.) Don’t bill the CPT code or codes for a lesser service or to describe the work done. Remember... paint a clear picture.

-59 This is the leader of the problematic pack, in more ways than one. It’s a problem for coders, when to append it and when not too. It’s a problem for doctors, billers and office management, bill it on everything that bundles…or well, just everything for safety sake. It’s a problem for claims submission, what end of the modifier chain to I add it to? See what I mean? It’s just a genuine pain in the medical ... well, you get the idea. This modifier is known as “The Magic Unbundling Modifier”. It’s always used when more than one procedure is performed on the same day. It also replaces -51 when billing for two or more procedures on the same date of service that bundle into each other. You can have this modifier on one code or ten. What happens when you use this modifier is you are telling the insurance company (or most likely their claims scrubber at their electronic front door) that “you understand the codes you are billing normally bundle into each other. However, under this particular circumstance they were done independently of each other and therefore both (or more) are separately reportable and payable. This modifier can get any physician into a great deal of trouble, hence the reason it is constantly on the OIG Most Wanted List. Unusually high usage of this modifier can put anyone under an uncomfortable amount of scrutiny. Knowing when to use this is modifier can be as simple as asking yourself a simple question “is the bundled code reporting a portion of the procedure that was done as part of the unbundled code”. For example, in order to perform an open procedure on a patient the surgeon has to make a surgical incision, right? Well, you wouldn’t expect to get paid for opening the patient or closing them for that matter when you are billing for the service provided once they were opened up, right? The physician is expected to close/open the patient…it’s part of the procedure. Therefore the work for it is included in the primary procedure. With this logic you can look at any procedure with the same view. Ask yourself these questions; “Is it a different anatomical site (different incision, different organ or vessel, opposite side for example, remember different codes are being billed).” “Is it for a separate medical reason?” “Is this at a separate encounter (same day)?” If your answer is yes to any of these questions, then your bundled code is most likely billable. If your answer is no, then you should look closely at your procedure again. Most likely the bundled code is included in the larger service and not separately billable. Remember those lysis of adhesions we talked about? In most open procedures, unless this is the only procedure being done, these are almost always bundled into the greater service. Think about it logically, the surgeon most likely had to move them out of the way in order address the main problem. If it took a great deal of time to take them down, then with good dictation, you can always fall back on modifier -22. Since this modifier is the unbundling modifier, it’s going to be the modifier that gets the claim through that proverbial electronic front door. I like to think of a big, bad, scary, electronic bouncer called Chip. Without the right modifier leading the way, the claim will get bounced before it even gets a chance to plead its case. Kind of like the metal detector at the court house. Just be careful to use it wisely. I think every doctor looks better in a white lab coat as opposed to an orange jumpsuit. Besides orange is a hard color to pull off, unless you have a real nice olive skin tone, you know those ones that look good in … Oops, sorry got off track again.

Well, since our minds are beginning to wander we’ll get out of the modifier neighborhood while we’re ahead of ourselves. This is a lot to tackle in one day and much to absorb. I think we’ll come back next time to take on the last of our dastardly criminals of confusion. Like any gang, get each member alone and eventually they all crack. Be sure to grab a buddy getting out of this neighborhood… I don’t want anyone getting left behind.

Until we meet again!

--Tara

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TeleWebinar Update

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

Shared Document Collection Initiative:

I am spearheading a collection of forms and documents to upload and provide for download in the shared document section of the CRN forums. I plan on doing this topic by topic. The first topic is Self pay and financial policy forms. I am collecting forms related to self pay policies, non participation, cash services (non covered services) and financial policies. I will take the forms and then load them up onto the CRN in the Shared documents section for us all to use and download. Better yet, when you need them, they will be found via the search engine on the CRN Forums.

So, if you have a form to share with me and your fellow CRN members, please send it to me. The best is if it is in a word format, then you can email it to me directly, b.cobuzzi@att.net Or, if it is an adobe document (scanned or otherwise), similarly you can email it to me directly. 

If you do not have the form in an electronic format, you can fax to me and I will have to scan it (which will not have as good quality in shared documents, but we will take what we can get.) My fax number is 732-542-3824. Or, if you have a scanner, you can scan it to a PDF and email it to me at b.cobuzzi@att.net (that way it is one less scan than if it is faxed and scanned).

Thanks so much. This is one of many document collection initiatives that I am leading to beef up our shared documents and resources section of the CRN forums. I figured I would do it topic by topic. I look forward to your contributions.

Vacation was terrific with my family. My daughters got to re-know their mother and my husband re-meet his wife after all the travel I have been doing. It seems that my coding colleagues have gotten to see me more often than my family; I think many of the readers of this newsletter understands this all too well. Now I have a month at home to look forward to for the month of May and then off to travel again in May also. So, we have some plans to record some new telewebinars in May to add to our library of continuing education for the CRN Community.

Don’t forget the classes currently available, Employee Overtime-Is Your Practice At Compliance Risk? taught by Pati Trites. 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 for CRN Telewebinars 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, and required by law, there are a lot of small things you can do to start your compliance pathway. Compliance is not only a good idea from a regulatory point of view, but history has proven that good compliance is actually an excellent aspect in cost control, increased patient outcomes, patient satisfaction and increased employee satisfaction. 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.

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 of the most recent classes, 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. 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. 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 in June.

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

Mary Campbell, CPC, CCS-P

Where are you from?
Originally from Minneapolis, then lived in Wisconsin for 20+ yrs and now I live in the Silicon Valley area of California.

What is your favorite activity?
I am a volunteer at our local Humane Society where I am a dog socializer. I get to work with dogs who have found themselves homeless and hope to keep them social and happy so that when their forever family comes along they are ready to fit right in.

Do you have any hobbies?
Same as above, really. I also like to play on the computer, play cards, golf and just hang around at the beach.

What credentials do you hold?
CPC, CCS-P

What organizations do you belong to and how have they helped your career?
Just the AAPC at this time. I don’t know if it has helped me or not. I am not a very active member, I hate to admit. I do think it has helped my credibility and it clearly has helped with our newer staff members. We know that we are all on the same page when it comes to coding.

How did you get into the field of medical billing and coding?
I really just fell into it and found that I really love it! I began in Medical Records and an opportunity came along to take a class in Anatomy/ Physiology and Medical Terminology. I really was at the right place at the right time 22 yrs. ago!

What is your current position?
I am the Senior Reimbursement Analyst for a group of 270 physicians here in California. The main focus of my job is auditing and education of the physicians. All providers are audited yearly both in their routine visits and in their consultations. I now have a staff of 4 and it keeps us very, very busy!

What is one of your accomplishments in this field that you are most proud of?
I think I have been a mentor to many people that I work with. I’ve created tools that both the staff and physicians can use to help them in their daily coding.

What do you find most exciting about this field?
That it is ever changing!!

What do you find most frustrating?
Hmmm….ok, that it is ever changing!! In addition to the changes I get the most frustrated at the lack of true guidance when it comes to coding. I fear sometimes that we have gotten lost in the guidelines and taken away some of the common sense. In my heart I really don’t think this was the intent when the guidelines were created. Have we done that to ourselves by creating “coders”. I’m not sure, but I strive every day to keep some level of common sense in my auditing.

What do you feel the future holds for this field?
As technology advances I feel that the entire process will become more automated, and in reality more accurate. I think the Electronic Records are so exciting. Imagine having access to your medical records wherever you are seen!

What would you tell someone just starting out in this field?
Learn anatomy and medical terminology and then really get to know your doctors so you really understand what it is they are doing.

Who do you consider a mentor?
I’ve met so many smart talented people in this field who are so willing to pass along their knowledge that I have a hard time picking out one person.

What is your favorite billing or coding product?
Intelicode, CodeCorrect

What is your affiliation with the CRN and how has that helped you?
CRN is a group of such wonderful people who are full of knowledge and they are willing to share and learn from each other. You can’t put a price on that! I may not be online often but I know that if I need some help this is the place to come!

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For 2006, BillFlash.com has a fresh new look to continue to provide you the product leadership and marketing support you need to create substantial recurring income.

Current users will appreciate the following enhancements and have been notified of such:

• SIGN IN has been added directly on the home page to save clicks.

• Improved Menu structure and usability

The BIG NEWS is the site has been completely redesigned to help you sell more in the following ways:

• The site has a fresh and appealing new look.

• The home page now focuses on two marketing objectives:

  1) To view the DEMO
  2) To ENROLL

• We are promoting our compelling and unique ability to offer users retained CONTROL through eApprove while still obtaining OUTSOURCING EFFICIENCY.

• The Learn More section has been updated with easier to read and improved content. In particular, the Brochures and Samples pages now contain information in clear tables for faster location of desired materials.

• Our DEMO update, which will highlight these exciting improvements, will be released in late May

Congratulations to our newest members of the $5k, $10k, and $20k commission levels and thank you to all who fueled BillFlash’s extraordinary growth in 2005. We look forward to working with you to achieve your goals for establishing recurring income in 2006.

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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!

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