Certification Coaching Q & A Webinar
September 2015
This Month’s Q & A Webinar Agenda: 90-120 min
II: Q&A from our Instructors ● JoAnne: Radiology Coding● JoAnne: Back to Basics: CPC Coding/
payment policy
● Alicia: ICD-10 Code of myocardial infarction
● Alicia: Back to Basics: Practicode Case● Alicia: Lesions 10,000 Series● Alicia: Wound Care
● Laureen: Apligraf skin graft
I: Introduction● Why stay?● Where is everyone from?● Recent CCO Graduates/ You Too?● Announcements and Course Updates
IV: Your Questions in the Chat
III: Close - @ 90 min-’ish’● Wrapup● Drawing● CEU Certificate Download Link
Ask Along the way in the Questions box.
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CONGRATULATIONS to...
Tiffany Whilhem 8/15/2015 Passed CPC
Melanie Bleem 8/24/2015 Passed CPC
Sarah Lindahl 8/25/2015 Passed CPC
Denise Adkins 8/28/2015 Passed CPC
Lori Conley 8/30/2015 Passed CPC
Antonia Lopez 8/31/2015 Passed CPC
Lori Conley 9/4/2015 Passed CPC
Patricia May Exconde 9/5/2015 Passed CPC
Gail Quinn 9/5/2015 Passed CPC
Pam Schulman 9/12/2015 Passed CPC
Barbara Michelle Bess 9/13/2015 Passed CPC
Alicia Espinosa 9/14/2015 Passed CPC
CONGRATULATIONS to... Melody Mason 8/22/2015 Passed COC
Cindi Duran 8/26/2015 Passed ICD-10 Assessment
Angela Kline 8/28/2015 Passed ICD-10 Assessment
Kendra Johnson 9/4/2015 Passed ICD-10 Assessment
Marcia Hayes 9/9/2015 Passed ICD-10 Assessment
Katherine Jade Martinez 9/14/2015 Passed ICD-10 Assessment
Elizabeth Otto 9/15/2015 Passed ICD-10 Assessment
Anna Burnham 9/15/2015 Passed ICD-10 Assessment
Anna Burnham 9/15/2015 Completed FBC Course
Carol Swedensky 8/23/2015 Completed MTA+PBC Course
Madea DeHaven 9/5/2015 Completed MTA+PBC Course
Sarah Lindahl 8/25/2015 Completed PBC Course
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Alicia ScottCPC, CPC-I, CRC
Laureen JandroepCPC, CPC-I, COC, CMSCS,
CHCI, CPPM
MODIFIERS
Risk Adjustment/HCC
The Future of Coding >> ICD-10 Prep - CCO Style
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Risk Adjustment presented by Alicia Scott, CPC, CPC-I, CCO Education Director
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CCO Helpdesk
helpdesk.cco.us(You can search the knowledge base,
create a ticket and check up on existing tickets)
Poll - What region of the country are you from?
Poll
● JoAnne: Back to Basics - Radiology Coding● JoAnne: Back to Basics - Applying Coding to
Payment Policy
● Alicia: Back to Basics - Practicode Case ● Alicia: ICD-10 Coding of subsequent acute
myocardial infarction● Alicia: Lesions 10,000 Series ● Alicia: Wound Care
● Laureen: Apligraf skin graft
Coding Q and A Topics
Alicia ScottCPC, CPC-I, CRC
Jo-Anne SheehanCPC, CPC-I, CPPM
Laureen Jandroep CPC, CPC-I, COC, CMSCS,CHIC, CPPM
Back to Basics - Radiology Coding
Question: Can you elaborate and give tips on Radiology Coding?
ANSWER
Back to Basics - Applying Coding to Payment Policy
Question: Please explain CPC coding and payment policy.
ANSWER
Back to Basics - Practicode Case
Alicia presents a Practicode case
ANSWER
Poll
What AAPC coding credential do you HAVE?
ICD-10 Subsequent Acute Myocardial Infarction
This example comes from AAPC Quick Reference. I want to know why we need 2 codes. Is this only a ICD-10 rule? A patient suffers an acute MI of the inferior wall 2 weeks after suffering an acute MI of the left anterior descending coronary artery. He is admitted for the new MI. I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall I21.02 ST elevation (STEMI) myocardial infarction of left anterior descending coronary artery In this example, the second MI occurs within four weeks of the first, so it is a subsequent MI coded from category I22. The patient is admitted for the new MI, so the subsequent MI is the first listed ‐code, followed by the initial MI.
ANSWER
Poll
What coding credential do you WANT?
Wound Care
Question: Can you elaborate on wound care coding?
ANSWER
Lesions 10,000 Series
Question: I get confused when it comes to report per lesion and report number of lesions in the 10,000 series.
Please help!
ANSWER
Apligraf skin graft
Question: Can you go over coding for Apligraf skin graft procedures?
ANSWER
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Questions In The Chat
ANSWERS
Your Webinar Chat Team
Chat Q & AWebinar- Sept 2015
Modifier 33 and Vaccine
Can you shed any light on the modifier 33 and the Affordable Care Act and vaccine coding with a preventative visit?
Modifier 33 and Vaccine-Answer
A HCPCS Code G0121 is a colorectal screening colonoscopy on individual NOT MEETING criteria for high risk-DX V76.51 Screening colon cancer. If you use 45378 which is also a colonoscopy but it is a screening with V76.51, you would add modifier 33 to indicate it was a preventive.
G0179
What should I do for a patient with Medicare primary and BCBS of SC secondary and the physician office bills G0179. Medicare processes and pays, secondary is denying for invalid code?
G0179 - Answer
G0179 is a physician re-certification for MEDICARE-COVERED home health services under a home health plan of care. There is no CPT code that matches the exact description of this Medicare code so a secondary payment is highly unlikely.
Unspecified Codes
I have heard if you use unspecified codes the insurance companies are going to "PIN" the claims and request for additional documentation?? Is this true?
Unspecified Codes -Answer
Unspecified diagnosis codes are not typically queried unless a high level office visit (ex: 99215) is associated with an unspecified diagnosis not qualifying for such a high level of service. THEN you get flagged and documentation must be provided in order to get paid.
1995 or 1997 Guidelines
Q: Which guidelines do you suggest to use for E/M?1995 or 97?
A: I find that 1997 is the most common guidelines that physicians use. More comprehensive.
Modifiers Change
I'm trying to get an answer on how modifiers will change since ICD10 is so much more specific now. Like we will still be using modifiers in coding after ICD10 is implemented?
Modifiers Change-Answer
Modifiers are still required on CPT codes and must match the diagnosis code. Example, cerumen removal, bilateral 69210-50 and diagnosis code for impacted cerumen, bilateral is H61.23. The last character 3 indicates bilateral. If it ends in 0, it is unspecified, 1 is right ear, 2 is left ear.
Newborn 92586
Any insight on newborn hearing cpt 92586? Certain payers are denying inclusive to facility but we own the equipment and are providing tc and pc so not being billed with a 26 modifier.
Newborn 92586 - Answer
92586 seems to be listed strictly as global while 92585 and 92587 use 26 and TC. 92586 seems to just present as global.
Different kinds of coding
What is the difference between the different kinds of coding (CCA, CCS, RHIT, etc)
Hospital Follow-up
Can you have hosp follow-up as a chief complaint without any further details but follow-up?
Transition Care Management
Wouldn't a hospital follow up be a TCM? Transition Care Management? The patient has to be contacted by a certain time as well as other guidelines pertaining to TCM?
Code G83.23
Code G83.23 patient is left handed, for code G83.24 Monoplegia of upper limb affecting left non-dominant side, is patient left handed or right handed?
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