Be Your Own Medical Coding Consultant — VIDEO

Okay next was a segment that Alicia suggested. I like to kind of be my own medical coding consultant and that’s how we figure out the answers to these questions. We don’t know everything off the top of our head. Actually, I probably know 10% of your questions off the top of my head. But… and I always tell my students, you don’t have to know everything. You just know how… you need to know how to get the answer. That is truly what a good coder is.

Be Your Own Medical Coding Consultant- VIDEO

So these are our go-to references that we use all the time. Google is my number 1. AAPC forum, our own forums, going into the encoders like Find-A-Code, Supercoder, the CMS website, etc. So let me see what I worked up here. Hopefully, maybe something. Nothing? I thought I did.

Okay so let me just take you to Google instead. And a lot of people don’t realize that they’re… besides just typing in this box, there are advanced search options that you can do. And I recommend literally that you Google advanced Google search tips and you will learn so much that will help you in just your day to day Google use, let alone for coding. You can just type in a code and it will bring you that site. Like we were just looking up… what is 644? Where is that slide? I think… well, I’m just going to try 65 and see.

Now that’s probably going to bring up things like zip codes and whatever. But if you want to put CPT code in front of it, it might bring up some information. Is that the code, Alicia? I want to find the exact code here.

Alicia: The 64465?

Laureen: Yeah.

Alicia: Is that the one you’re…

Laureen: Hang on.

Alicia: I won’t be able tell you what that code…

Laureen: Hold on.

Alicia: Now you’re showing them you don’t have every code memorized.

Laureen: No I don’t.

Alicia: They tell you not to memorize codes.

Laureen: Okay, hold on here.

Alicia: The only one I had memorized is 99213.

Laureen: Here we go, 64495. Okay, there we go. And so when you popped it and you can start to see, okay Coding News is talking about this. Here’s the AAPC. And you can see, when they’ve got these indentations, they’re letting you know that there’s… not only is there a hit on AAPC, there’s 4 or 5 hits in like the discussion board. Denied CPT, here’s someone asking that same question and this is what I did to come up with the answer. So just try something like that, whatever code you’re struggling with and see what other people are saying about it. And a lot of times, you’ll see come up. Kind of cool.

Now if you know you want to search like say, our site, like , you can actually do it this way. And I do it all the time when I know we’ve written something and I want to find a link to give to someone in an email or in a discussion board. I’ll type in something like a job search and then you do space site colon and whatever site you want Google to search on that term. So I’m going to put coding, if I can spell my own site name. Okay so notice that format again. You’ve got the term you wanted to search, a space and then site colon and the website. There’s no spaces between the site colon and the name. And then you just hit enter and every single finding on here, you’ll notice, . So it’s finding everything that has the phrase job search in it. And as you can see, we’ve been very busy. A lot of blog articles, it’ll search the discussion board and the blog at the same time. We have separate search engines for the blog and a separate search engine for the forum. This searches the whole site so it’s pretty cool. I do it a lot on AAPC so that’s 64495 and I’m going to make it…

Actually, let me just show you this. This is how I found where the question was that the person asked. And now if I change it to aapc.com, now we can see all of the posts where people have been asking about it. So here’s one, “Help! Help!” so it’s obviously a common issue. And you can go find out how other people have handled it and you can check the dates. Obviously, you want probably more recent posts than older ones because coding information changes. But you can do that with the cms.gov website. I don’t think that will be on there but we can try that.

Alicia: While you’re looking at that, Leslie has posted that she uses that all the time when she’s looking up payer’s payment policies and stuff like that. That’ll pop up which is brilliant.

Laureen: Yeah perfect. So whatever your particular payer is, you can use that as a site. Figure out what their site address is and you can search just their site to see if they have a policy on a particular code or term.

Alright so that was Google. I showed you how to search… oh let me just show you like directly, if you go to aapc.com, we’re on here all the time but we forget that for students or people who don’t really visit the site frequently that it’s kind of overwhelming. It’s a very big site. So if you want to go to the discussion board, if you hover over networking, you’ll see the forum’s homepage. You… if you’re a member and logged in, it’ll bring you to your local chapter discussion board.

Let’s go to the forum’s homepage and now you can see all of the different categories. So if you’re a student, you can go click in the student forum and see what they’re talking about. I visit that almost every day. And there’s general discussion, billing and reimbursement, ICD 10. So a lot of good information here.

But did you know, you could actually search… you can use my little site thing or if you know you just want to look at the forums, you can come here and use search. And we’ll use our code again and now it brings up every single post that has that code in it. So a lot more than what we got when we did it with Google. So all discussion boards, by the way, have some sort of search functionality, just… there’s maybe like 3 main discussion board programs out there or software. So just look for the little search box. And for ours, we have it right here, right at the tippy top. You can search titles only. If you want to see everything Alicia’s written since she’s so prolific, you can put in her id. And if you want… maybe you haven’t visited the forum in a while, you want to see anything that’s been posted in the last you know, couple of weeks. You can do that.

Since we’re here, I also want to show people that you can subscribe to these forums. I’m already subscribed to them so I’m not sure if I’ll be able to show you. Let me log out. No, that’s not what I want to do.

So let’s say you want to subscribe to the Stay Certified one. If you click on it in the upper right hand corner, mine says “unwatch” because I’m already ‘watching” it. But if you want to watch it… let me unwatch it then I’ll watch it. So now you click “watch forum” and then you can say email me every time there’s a new post. So if you wondered like how Alicia and I and Ruth are jumping on your questions and answering so fast, it’s because we’re watching it. We get an email as soon as you post your question. So if we don’t have time to answer it, we normally kind of set it aside. But if you want to be aware of every single email that’s gone on the discussion board, do this. If you just want… for when it’s a new thread, just keep this checked. If you want the new thread and all replies then you can check that and just click “watch forum”. So that’s a handy dandy tip.

Now encoders, you’ve seen me use Find-A-Code all the time. Someone asked in the chat just a moment ago if Find-A-Code is free. Find-A-Code has lots of free stuff and some paid stuff. Anything having to do with CPT, they have to charge you for. But ICD 9 and ICD 10 are free. Now if you start digging in and want more details it might say, “Oh sorry, you need a membership for that.” Let me see if I’m logged in… yes, I am. Okay.

So on this screen and all encoders are a little bit different. But for the most part, they’re tables of codes and information and articles and things like that. And there’s pros and cons to all of them. I love Find-A-Code. I love Supercoder. Those are my two main ones. But I use another one my day job and I like that for even other reasons. So just fine which one you like. I’m going to be doing probably a separate segment just on a shoot out, if you will, of the different encoders. Normally with students, they’re using their paper books but sometimes, it’s nice to just have an encoder real quick. And once you get done with your certification, you might be able to live by just using an encoder.

So they obviously have the search boxes here. I could put my 64495 and you can say, “Well, I just want to search CPT or whatever.” If you wanted to search everything and just pick what you want, they found my code. I can click on it and it gives me as if I read it in the CPT, the exact definition. It gives me the AMA guidelines from the manual. This is my favorite part of Find-A-Code is the plain English description. Then you’ve got additional code information.

This comes from the Medicare Fee Schedule database and we touched on that briefly when I had talked about CCI edits in the past. So again, they’re just taking tons of information out there and try to consolidate it in one umbrella. And you can know… does this have any global days attached with it? Does it have PC or TC indicator like you know, does this have a professional and technical component? Is it… does it qualify for bilateral surgery? All this good information.

Alicia: It also has HCC codes on there too, I noticed when I was doing that. It does the HCC code. It doesn’t do the RX code HCC code but if anybody’s doing HCC coding, it gives you a heads up.

Laureen: Code history, it’ll just let you know when it was added, when it was revised. My version, I’ve got the full package here so I get all the dictionary definitions and you know, that kind of stuff. You can add your own notes to a lot of encoders to remind you of things. If you’re on the job and you’re working for say, a cardiologist and you always come up against this coding, you want to remind yourself of something about it. You could create your own notes here.

Articles and newsletters, sometimes I find things in Find-A-Code. Sometimes I find them in Supercoder. It really depends like Decision Health uses these coder pink sheets. AMA reveals reasoning behind new facet… stimulator codes. I’m trying to see if they had… bilateral facet joint injections so you could look at that. And this is similar to what we were just answering, if you’re injected both sides of the spine, append modifier 50. So you can get you know, confirmation.

Now this is all paid information. But the ICD is free so if I log out… by the way, if you do sign up for Find-A-Code, there is a coupon code box. If you put in CCO, you will get a $60 discount. So the code for that is CCO. And if you do that, just let me know.

Alicia: They want to know how much it is. Do you know off the top of your head, by the way?

Laureen: No, I don’t. Sorry.

Alicia: Okay.

Laureen: Alright, what was I going to do? Oh okay now this is why I like this. I came in for ICD 10. You have the index so you could just look up… what was one of the things you were just doing?

Alicia: 401.9 is fun one.

Laureen: No, like an index phrase…

Alicia: Oh yeah.

Laureen: So if you were using a real manual, you’d type in your main term or you’d look up your main term diabetes. Well here, it does it for you. You just click the plus sign and you look at all the subterms. And then you can look at sub-subterms. So I really like it for that. This part is free, by the way. I am not logged in.

Let’s see if the Build the Code works. This is really cool. Here it is, Build the Code. Okay so ICD 10 is not showing up so that must not be a freebie one. So let’s just do ICD 9. And so Build the Code is like, “Okay, I want to code something from diseases of the endocrine system.” And then it comes down and you can pick… okay, it’s going to be other endocrine glands, diabetes. And it’s going to be the one with ketoacidosis. And is it uncontrolled… yes, we’re going to do this. And it’s actually built a code for us over here, 250.11 which I think is kind of cool. And you can do that if you have a subscription with the ICD 10 which ICD 10 really lends itself to this.

So that’s Find A Code and my other “fave” is Supercoder. And it’s a little bit different interface. You can still type in your code and you kind of get used to them. You tend to like whatever your first one is. But… so here it gives a code descriptor. We’ve got a lay term here, CPT guidelines. And on theirs, they’ve got the articles over to the side and they break it down by CPT assistant. If you’re paying for that extra CMS guidance, you’ve got some compliance tools. So you know, an online encoder is very valuable. You can normally get a trial for either a couple of weeks or even a month. So try it out, see what you like, look at the prices and see if one fits best for your needs.

CMS.gov has a plethora of information. They have a search box right up here that you can use. I don’t… I’m trying to think of another… let’s try CCI edits. And it kind of gives you a Google-looking results page and you can go in and… okay, this kind of looks like what I want. So that’s pretty much how you know, easy it is to search CMS. What’s frustrating to me for CMS is a lot of times, they don’t have what I call friendly URLs. So if you want to like dig in deeper, sometimes you have to say, “Alright, go to this page” and that’s as far as you can get. And then you have to say, “Click on NCI eye transmittals to the left and then scroll down and do this.” They’re getting better at it but it’s pretty cool.

Alright, Drugs.com, I think that’s one that Alicia visits.

Alicia: I use it daily.

Laureen: You use drugs daily?

Alicia: Drugs and drugs.com. The HCC coding, if a person is taking a drug, it’s a specific medication, it’s enough to support it, so you can code it. So a lot of those drugs you know, if they do the generics, I don’t know the name and you just type it in real quick and wow, it gives you the information.

Laureen: You got an example that you did?

Alicia: Yeah, type in Nadolol. Type in Lisinopril.

Laureen: There you go.

Alicia: Even if you spell it wrong, it asks you, “Did you mean this drug?” There you go. So see where… the one with a little star? Usually you don’t… I don’t even have to read. I can say, “Okay, that’s for high blood pressure.” But if you click on that with a star, it gives you all of that information. And then you can read more about it. It’s so fast and easy. The only thing that I have to say, it’s a bit embarrassing is that the little pop ups, after you’ve put in a few drugs, the little pop ups on the side keep showing you things that… and mind you, I’m coding for you know, geriatric patients. ED comes up a lot and some days… it’s a little embarrassing. I’m thinking, “Why do they keep flashing these ads?”

Laureen: That’s cool. So it’ll even tell you how to pronounce it. There you go.

Alicia: That’s right. It’s wonderful.

Laureen: Very good. And then the other one was WebMD, is that it? No, it doesn’t look like it.

Alicia: I think it’s not .com. Maybe it’s .org.

Laureen: There you go.

Alicia: My husband really likes this. If he has a single ache or pain of any kind, he looks it up. And unfortunately though, if you’re a hypochondriac, you don’t want to use this website.

Laureen: Very good. So you use that when you’re trying to look up certain conditions?

Alicia: Yes because this website will actually tell you what medications go with you know, say if it’s diabetes and there’s a new medication or something, you can type in diabetes and it will you know, it’ll even break it down into the manifestations and stuff like that. So you can get information real quick. As long as you don’t get hung up on some of these extra, there’s ads in there too and stuff. But look, type 2 diabetes in children, there’s an article. You know, so it’s a great resource.

Laureen: And the idea of this is really for the end consumer like the average person trying to look up things. But it can help coders to give us that missing information to help us make correct coding choices.

Alicia: Yes.

Laureen: Great, alright. Well, that’s a little bit on how to be your own medical coding consultant. So when you have a coding question, don’t feel like you’re stuck. Try and figure it out and you’ll learn so much. Sometimes, it’ll be like, “Oh my God, that was 2 hours ago.” Because you just keep going and going and going, searching around. But you know, the joke in my house is you know, I have a couple of nieces and they’ll ask me questions. I said, “Did you Google it?” It’s like you’re not allowed to ask me until you try to figure it out on your own. So they’re like, “I think that’s how I’m going to raise my kids. I’m going to make them Google everything.” “Why is the sky blue, mommy?” Google it.

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