Career Step, LLC Spring 2012

Career Step Quality Medical Coding Training • 4692 N. 300 W. Suite 150 • Provo, UT 84604 • www.careerstep.com • Ph: 800-246-STEP

Graduates . . . . . . . . . . . . . .2

Graduate Spotlight . . . . 4

Med Gab Answers . . . . . 4

Student Spotlight . . . . . .5

Layman’s Medical Terms 5

Dear Cari . . . . . . . . . . . . . . .6

MedicalCODING

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Employer Followup

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Welcome to your first day of sales training. If you are beginning to

shift uncomfortably in your seat and starting to look for the door, please remain seated. You may think that you graduated from a medical coding program to begin your career as a medical coder, that there must be a mistake, and that you must be in the wrong place, but you are not.

As a graduate of the training program, you are now beginning your journey as job seeker, in which you will “sell” yourself, your skills, and your abilities to potential employers. Therefore, many of the same techniques you use to become an effective salesperson, you can apply to your job search. We have already looked at resumes and interviews in depth in previous issues, so today we are going to specifically look at one very important aspect of the hiring process: following up.

Many graduates are hesitant to follow up because they are worried they will be bothering the employer; they don’t want to become an annoying, pushy,

desperate, or overbearing applicant. However, following up also helps you to become a persistent, interested, organized applicant that takes impressive initiative. So where is the line? How often is too often and how much is too much?

Here are three tips to help you make sure you aren’t crossing the line, but are still getting the information you need:

1. Act according to the employer’s timeline.If you are given a specific timeline, keep that in mind. If you are asked to check back in a week, check back in a week, not earlier. If you are not given a specific timeline, try and make the timeline more specific by initiating the contact. For example: Employer: “It was great to meet with you. We’ll let you know.” Applicant: “If I haven’t heard from you in a week, would it be okay for me to follow up with you?” Oftentimes, applicants make too many calls because their timeline is indefinite or unknown, but your contact will remain positive when

you define a timeline and act according to their expectations.

2. Stay positive and persistent.Never fall into the trap of assuming “If they were interested, they’d call me.” Most of the time, that is the case, but if a buyer is considering two good products and one company calls back first to make a more positive impression, they are likely to go with the second. The same applies to an employer considering two good applicants for a job.

Continue and follow up and express interest about each position for which you applied. If an employer lets you know you were not selected, evaluate

A Lesson in Sales

Spring 2012 MEDICAL CODING BULLETIN2

GRADUATESAndrea Neske – St . Charles, MO Career Step definitely prepared me for the real working world. I passed my CPC exam on the first try only 1 month after graduating and then was able to obtain a position as an inpatient coder for a cardiovascular practice within 3 months. My employer was so impressed with me being able to accomplish these goals on my own that they decided to give me a chance at a position normally reserved for someone who’s coded for at least 5 years. Now that I have started I feel very well prepared for this job! And I feel a great sense of pride and accomplishment.

Barb Hultin – Hillsboro, NDI have worked in the healthcare industry for over 20 years, and I went into the class thinking that there wasn’t much they could teach me that I already didn’t know. Boy, was I wrong! Not only did I gain the knowledge needed to be a Coding and Billing Specialist, but I learned about many other aspects of the healthcare system and healthcare services. I did the class at my own pace, which was so helpful as there was a period of time that I had to walk away from the classes for a couple of months. After being away for awhile, it was easy to review the information that I had already gone through and start right back where I left off. When I was gone for that period of time, the people from Career Step did not just forget about me, I often got reminders and hints about how to get back into the swing of things and budget my time to keep working on the degree. They were also prompt with their feedback, giving understandable explanations anytime I had a question. I feel the information given to me in all the modules was thorough and very pertinent for learning the ins and outs of medical coding and billing. In addition, I never got bored with any of the material and found it all to be very interesting. I would definitely recommend the Medical Coding and Billing training program to anyone who might be considering making that career step!

Carol Adame – Lafayette, ORI will always be thankful for the lessons I learned while taking this course. I enjoyed the care and help extended to me to succeed and graduate. I will be applying this knowledge in my current journey to locate a job suited for the abilities I now have to offer. Thank you!

Danita Allen – Wray, COI enjoyed my Career Step course very much. I learned a great deal and graduated with high honors. I took my CCA exam and passed. I am now working in coding at the Wray Community District Hospital, doing mostly outpatient coding. I am working on my CEUs for my certification. I am learning about ICD-10, and I am hoping to get my CCS before ICD-10 goes into effect. I would recommend the Career Step program to anyone interested in coding. I want to thank everyone at Career Step that made my experience so great; Cari and Randy at Career Step and Lisa at Arapahoe Community College were all very helpful. Randy answered a lot of my questions and Lisa allowed me to take part in the monthly groups and even faxed me the info since I could not go to the group in person.Thank you everyone!!!!

Ed Peterson – Joliet, ILThe Career Step experience was great, and I would highly recommend it to anyone interested in learning the trade. The modules built upon each other, which made it easy for an older student like me to follow along at my own pace. The forums also helped me to know that others were experiencing the same difficulties that I was experiencing. The coursework really does prepare one well for the exam. I would highly recommend Career Step, and I am now anxiously looking forward to becoming certified and actively working in the coding and billing field.

Leslie Montgomery – Littleton, CAHello fellow coders, I would like to share with you my experience going through the coding graduation and certification. First, I would encourage you to complete your education in coding. Secondly, after graduation, get your certification either through AAPC or AHIMA. It will make a difference when you’re seeking employment. Thirdly and perhaps most importantly, make sure you are open to ideas on how to incorporate coding into a new job. After I graduated from Career Step and saw that most jobs required experience, I entered the job market from another direction. I really enjoy medical records so I went through another online training program and received a certification in Records Information Management. When I did that, it opened a lot more doors for me for possible employment. I could easily combine the two areas, thus increasing my chances for a job. I graduated

in December 2011, took my CPC a few weeks later and passed, and just got a job doing chart auditing and compliance where I can utilize coding skills along with medical records expertise. Focus on thinking outside the box, be creative, and don’t give up! I also wanted to thank Jenae for her expertise in resume building. One of the first things that the director I was interviewing with mentioned was that she was so impressed my resume was only one page!

Michelle Willis – Tennille, GACareer Step has really prepared me to work in the world of coding and billing. I highly recommend this course to anyone. Thanks, Career Step!

Michelle Barra – Huntersville, NCI recently completed the Medical Coding and Billing Program and graduated with high honors. I found the whole program very thorough and challenging, and it prepared me well for the Career Step final exam and the AAPC CPC certification exam, passing both on my first try. Randy Johnson and Cari Greenwood were both very professional and very helpful in answering my questions throughout the program, and Jenae Walker was very helpful with the group consultations during the program and has been wonderful with the employment tips and assistance since I’ve graduated. I learned so much, enjoyed the training, and feel I am ready for my career in coding. I am very thankful for all of the assistance that I received from Randy, Cari, and Jenae throughout the program and continue to receive from Jenae in my job search.

Suzette Hunley – Roxboro, NCI am currently employed at Roxboro MedAccess Urgent Care, North Carolina’s first certified urgent care center. I am expecting to take my certification exam in the next month or so. Career Step offered a very challenging course, but it is well worth it!

Tiffany Bobbitt – Warrensburg, MOThe Career Step course was excellent in preparing me for my job! I really appreciate all the support and help offered and given through the Career Step staff. Thank you for a wonderful experience! I’m currently working at a pediatrics office in Blue Springs, MO.

MEDICAL CODING BULLETIN Spring 2012 3

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what you learned and move forward. Accept defeat gracefully by sending a followup thank you email or letter thanking them for their consideration and expressing your availability and interest if there are any future openings. Many individuals do not take advantage of this last way to make a positive and professional impression with an employer. It will set you apart and make you more memorable if a future position opens up.

3. Change it up!To ensure your followup is effective and meaningful, do not continuously approach the same person in the same way with the same information.

CHANGE INFORMATION: WHAT YOU ARE SAYING OR ASKINGShowing up at someone’s door to sell a product is a lot like introducing yourself or making that first contact in an interview. If a door-to-door salesman showed up with the same information as they did the day before, you might be agitated, but if they presented you with some positive user reviews, a short demonstration, or told you about an upcoming discount, the new information might persuade you to make a purchase. Follow up by providing an employer with your references or letters of recommendation. Consider following

up when you’ve reached key points in your training and career—beginning the coding modules, working in the practicum of the program, passing your final exam, and passing your certification exam. Rather than contacting an employer over and over to say, “Are you interested, are you interested now, are you interested NOW?”, you are presenting them with new information that is likely to help you in landing the job.

CHANGE INDIVIDUALS: WHO YOU ARE CONTACTINGTalking to more than one of the decision makers means you’re more likely to make a sale. It is important to develop as many contacts as you can within a company so you can leave a positive impression with as many individuals as possible. A loose rule to follow in an employment search is that you have the permission to contact anyone that’s given you contact information at any point; however, you should be sure not to overstep the boundaries the company has set. If you interview, speak with, or receive assistance from more than one individual within a company, be sure to thank each one personally.

CHANGE APPROACH: HOW YOU CONTACT THEMThere are many ways to follow up—over the phone, by email or letter, and in person. If you contact a company to ask about volunteering and you leave

a voicemail or send an email without receiving a reply, consider visiting in person to present your resume and talk to someone onsite. Varying your approach helps to ensure you are not coming across in a negative way and also helps to ensure you are making the most of all avenues of a job search.

When you implement good sales practices into your job search, you are ensuring that you are “selling” your skills as best as you can to an employer. Organized and strategic followup can be key to an effective job search; thus it is a good skill to master early on.

- Jenae WalkerCS Coding Support Team

Career Step Congratulates Our Recent Graduates Adam – Clinton, MOAmanda – Beaufort, SCAndrea – St . Charles, MOAnne – Littleton, COBarb – Hillsboro, NDBeth – Clovis, CABeverly – Roseville, CACari – LaMoille, ILCarole – Lafayette, ORCelia – Redmond, WAChelsea – Clarksburg, WVChristie Lyn – Colorado Springs, COConnie – St . Pauls, NCCynthia – Hickory, NCDanita – Wray, CODavid – Salt Lake City, UTDebra – Whiting, IADeidre – Fayetteville, NCDiane – Centralia, WA

Edward – Joliet, ILEmily – Ellsworth AFB, SDEva – Ft . Mill, SCGail – Calabash, NCHeidi – Pleasant Grove, UTIleana – Cameron, NCJamie – Tucson, AZJeanette – Esko, MNJessica – Sioux Falls, SDJessica – Johnstown, PAJoanna – Renton, WAJulie – Alvin, TXKayla – Streator, ILKelly – Plainfield, ILKeri – Coos Bay, ORKim – Lake Placid, FLLauren – Ottawa, ILLeah – Ridgecrest, CALeslie – Littleton, CO

Lisa – Gainesville, FLLisa – Canton, NCLynelle – Thorndike, MEMaria – Maplesville, ALMark – Marengo, IAMary – Myrtle Beach, SCMegan – Veneta, ORMichele – Buzzards Bay, MAMichelle – Huntersville, NCMichelle – Clarksville, TNMichelle – Tennille, GANikkeyta – Shakopee, MNPreetha – Birmingham, ALRaquel – Hatillo, PRRaul – Desert Hot Springs, CARebecca – Austin, TXRebecca – Alexander, NCRuslana – Savage, MNSandra – Peyton, CO

Sharon – Streator, ILSharon – Rock Hill, SCSharrie – Lees Summit, MOStephen – Fryeburg, MESusan – Prior Lake, MNSusan – Hemet, CASuzanne – Irving, TXSuzette – Roxboro, NCTiffany – Coos Bay, ORTiffany – Warrensburg, MOValerie – Centennial, COVickie Sue – Lexington, KYWanda – Enterprise, ALWanda – Fayetteville, NCXueqing – Damascus, MD

Spring 2012 MEDICAL CODING BULLETIN4

Graduate in the Spotlight -Regina Faulkner, CPC

After 30 years in banking I was ready for a change and when my daughter

started college, I realized it was my opportunity, but I had no idea what I wanted to do. I researched schools and options, and I kept coming across medical billing and coding careers and the expected growth in this industry over the next 15 years. Not being one to jump into anything quickly, I began to research schools and what they had to offer.

I will tell you that there are excellent, well-known schools here in the Nashville, TN area. Many potential employers know them and like to interview their graduates. My goal though was to find the best qualified school to teach me and prepare me for my new career. Many of the schools I spoke with wanted to offer me the quick start 3 or 4 month training to pass the CPC exam. That’s all. On one hand that’s great --after all, you must

pass the CPC exam if you’re serious about a coding career. On the other hand, if you don’t know the ins and outs of coding and aren’t able to do it correctly from the get go, you will be dazed at your lack of knowledge, disappointed you cannot code accurately, and may lose your first job because there’s little room for errors in this business. Getting the education and passing the CPC exam does not guarantee you employment if you can’t pass employer coding exams to get hired, and believe me, you will be asked to show them what you can do.

For that reason, I chose Career Step, and employers are amazed that I am able to code with 98% accuracy, especially when the standard is 95%. This speaks volumes about the quality of my education. Career Step was at the forefront of all schools for me. From the first day I began the course, through the intense practicum and final exam, I had to stay focused and keep my nose to the grind. It was not easy but it was the best! Coders that I have talked with are shocked at the training I received and say they wish they had gone through Career Step. No other school that I have

found requires that you accurately code over 500 reports during the process, and Career Step’s cost of tuition is considerably less than many of the other schools I spoke with.

In a nutshell, the Career Step Billing and Coding Program is the most aggressive, in-depth program you could ever hope for. I could pick up the telephone and talk to a person anytime or email someone and have an answer immediately. My career counselor was there to advise me, tell me where the opportunities were, and sent me numerous emails with job listings in my area. She called or emailed me consistently to see where I was in my job search until I nailed my first position! She critiqued my resume and even offered to call prospective employers about the education I had received at Career Step. It’s going on two years since I graduated from Career Step, and I still hear from her all the time. It doesn’t get any better than that!

- Regina Faulkner, CPC

Winter 2012 Med Gab AnswersIn the winter 2012 issue of the Coding Bulletin, we included a Med Gab Challenge. If you didn’t get a chance to play the game, revisit the last issue of the Coding Bulletin before peeking at the answers included here. If you’ve been waiting to see which ones you got right, now is your chance:

1. Doogie Howser2. Royal Pains3. Mobile Army Surgical Hospital (MASH)4. Cliff Huxtable5. Northern Exposure6. Private Practice7. ER8. Doctor Quinn Medicine Woman9. General Hospital10. Gregory House

MEDICAL CODING BULLETIN Spring 2012

Student in the Spotlight - Marisa Nish

My name is Marisa Nish. I was born in Salt Lake City, Utah and raised in

Provo. I am the oldest of three children in my family. In my spare time I enjoy reading, watching movies, swimming, and traveling. When I started college in the fall of 2003, I initially wanted to be an elementary school teacher. When that didn’t work out, I switched my focus to an area I was equally passionate about: healthcare.

Having been born with cerebral palsy, the healthcare field was something that was very familiar to me. I was used to being in hospitals on a regular basis as well as interacting with various doctors and nurses. These early experiences helped cultivate in me not only a genuine love and respect for those in the healthcare industry, but also a deep desire to be like them.

In the winter of 2011, I graduated with my bachelor’s degree from Utah Valley University in Public and Community Health. After a few months of job searching with no success, I decided to improve my odds of getting a job with more specialized training. It was while researching my various options that I came across the medical billing and coding program available through Career Step. Granted, I had no idea what medical billing and coding was, but I chose it for a couple of different reasons. First, it sounded like an interesting profession and one that I could do well. Second, it was something that would give me stable employment. And finally, it would allow me to work in a variety of locations such as at home, in a doctor’s office, or at a major healthcare provider.

While working through the program, I have learned a lot and continue to learn as I go. This is not to say that learning has been without its challenges. There are many times when I have gotten discouraged with myself and even questioned my ability to successfully

complete the course. However, with the help of the coding support team, I have come to realize that I’m not alone and that there are other students out there with the same struggles that I have. I also recognize that there is a learning curve associated with every type of job and that it will take time for me to feel comfortable with what I’m doing. With that in mind, I keep moving forward, doing a little bit every day knowing that while it may be difficult at times, if I try hard and if I really want it, I can do it!

- Marisa Nish

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Layman’s Dictionary of Medical Terms

Anti-Body : against everyoneArtery : study of paintings Bandages : The Rolling Stones Bacteria : back door to a cafeteria Barium : what to do when treatment fails (Bury ‘em)Botulism : tendency to make mistakesBowel : letters like A E I O or U Caesarean Section : a district in Rome Cardiology : advanced study of card gamesCat Scan : searching for one’s lost kittyCauterise : made eye contact with her Coma : punctuation mark Congenital : friendlyCortisone : the local courthouse Dilate : to live long (Die late)

4692 N. 300 W. Suite 150 Provo, UT 84604

MEDICAL CODING BULLETIN Spring 2012 6

Dear Cari...of the documentation for any other information it might contain about what is going on with this visit. The statement in the documentation says, “…the lumbar epidural steroid injection, which we had completed at his last visit, did give him good relief of his pain; however, his pain has returned, and he would like to have a repeat injection today.” This indicates that this patient is presenting due to the pain caused by the lumbar DDD, not for treatment directed at the DDD itself.

Coding guideline 6.a.1.a says:“Category 338 codes are acceptable as principal diagnosis or the first listed code: when pain control or pain management is the reason for the

admission/encounter (e.g., a patient with displaced intervertebral disc, nerve impingement and severe back pain presents for injection of steroid into the spinal canal). The underlying cause of

the pain should be reported as an additional diagnosis, if known.”

To code accurately for these types of visits, the coder must take into account not only the presenting problem but also the underlying reason or motivation for the visit.

Happy Coding!

- Cari Greenwood, CCS, CPCCS Student Support Team

Dear Cari,

In the report I’m coding, the diagnosis in the assessment is listed as lumbar degenerative disk disease, but the code for the primary diagnosis in the answer key is 338.29, chronic pain. Why isn’t the code for lumbar degenerative disk disease the primary diagnosis code?

Thanks,

- Bewildered in Boston

Dear Bewildered,

Degenerative disk disease is a con-dition that creates chronic pain problems for a patient. Although the providers list lumbar DDD in the assessment, we have to read the rest