Announces New 3-Day CPC-H® Training Camps

(1888PressRelease) April 22, 2009 – Naples, FL — is proud to announce the addition of new CPC-H® Training Camps, offering seasoned coders who want to become a Certified Professional Coder-Hospital (CPC-H®), the opportunity to prepare for the AAPC’s CPC-H® exam in just 3 days.

“We are very excited about the addition of the CPC-H® camps,” said Director Lacy Keith. “Because credentialed coders are in such high demand, our focus continues to be providing the best possible preparation so that our attendees can achieve their certification goals, increase their coding knowledge, and remain competitive.”

CPC-H® Course Description at a glance:

• Exam Taking Tips: You’ll learn what the exam expects you to know, what format you can expect, and what you can skip. Every day, you’ll tackle and review practice questions so that you’re prepared for the real thing.

• Make the most of “open book.” Our expert instructor shows you her unique way to tag and highlight your coding reference books so that you can move fast from question to question.

• Time management skills that help you pass. You’ve got 5-1/2 hours – Successful exam takers reveal where the exam tries to trip you up.

• Medical Terminology: Get a review of elements used in medical terminology (root words, prefixes, and terms related to the body system).

• Payment Methodologies: Get the inside scoop on areas such as outpatient facilities, medical records, emergency departments, admitting, and billing offices, CDM, outpatient hospital ASC, and OPPS and compliance.

• Radiology, Pathology & Laboratory & Medicine: In this session, you’ll venture into parts of the CPT book that may be very unfamiliar, and much more.

It is recommended that medical coders have a minimum of 2 years work experience in either a hospital facility or physician office before joining a CPC-H® Training Camp. CPC®, CCS-P® and CCS-A® coders are also great candidates for the CPC-H® Training camp.

For more information, call 866-458-2962 or visit


Alert coders about new guidance for coding body mass index and pressure ulcers

APRIL 22, 2009 —
Alert coders about new guidance for coding body mass index and pressure ulcers
Hospitals around the country face a new challenge: teaching coders that they can, in certain circumstances, use documentation from nonphysician providers to code pressure ulcer stage and body mass index (BMI).

New guidance, which appears in the updated ICD-9-CM Official Guidelines for Coding and Reporting and Coding Clinic, fourth quarter 2008, took effect October 1, 2008. It gives coders the ability to code the stage, not the site, of a pressure ulcer based on documentation from a nurse or other clinician.

The same Coding Clinic reminds coders that they can code a patient’s BMI using documentation from a dietitian when the BMI has clinical significance to the patient encounter. (Guidance on this topic first appeared in Coding Clinic in 2005.)
In both cases, the patient’s physician—and not a nonphysician provider—must still document an associated diagnosis, such as pressure ulcer site or obesity.

“These are basically like add-on codes,” says DeAnne W. Bloomquist, RHIT, CCS, president and chief consultant at Mid-Continent Coding, Inc., in Overland Park, KS. “You still have to get a diagnosis from a doctor.”

Although this BMI guidance is new to the official coding guidelines, it is not the first directive issued on the topic. Coding Clinic, fourth quarter 2005, stated that coders could code BMI based on notes from dietitians.

Incorporating this guidance into the official coding guidelines is a positive step toward recognizing the importance of documentation provided by other clinicians, particularly in terms of patient care and data monitoring processes, says Shannon E. McCall, RHIA, CCS, CPC-I, director of HIM and coding at HCPro, Inc., in Chesterfield, VA, and veteran instructor of HCPro’s Certified Coder Book Camp®–Inpatient and Original versions.

“Dietitians routinely would gather [BMI] as part of their analysis,” McCall says. Dietitians also analyze BMI fluctuations (e.g., higher BMI due to extra muscle mass or pregnancy) and understand the BMI’s limitations. For example, the calculation to determine BMI takes into account height and weight, but not muscle mass. Dietitians have an innate ability to use BMI to make judgment calls about medical nutrition therapy, McCall adds.

Coders can use nonphysician documentation of BMI only when the following conditions are met:

The documentation includes physician notation of a clinical condition such as obesity or malnutrition
The BMI has clinical relevance to the patient and meets at least one criterion for a reportable additional diagnosis (i.e., requires clinical evaluation, therapeutic treatment, diagnostic procedures, an extended length of stay, or increased nursing care and monitoring)
When the documentation from the physician and the dietitian don’t match, coders must query the physician.

The latest reminder and inclusion in the official coding guidelines is necessary to counteract recent inappropriate reporting of BMI, Bloomquist says.

“People were just indiscriminately slapping on the BMI codes when the doctor wasn’t documenting obesity,” she says, adding that they were even reporting normal BMIs, which typically have no bearing on patient treatment.

Coders should pay attention to the BMI number because it makes a difference in terms of reimbursement, Bloomquist says. A BMI of 40 or higher—diagnosis code V85.4—is considered a complicating condition, meaning higher reimbursement when coders report this code along with the appropriate principal diagnosis.

The same logic holds true for BMIs under 19. “That’s significantly underweight, so you would want some condition to go with that—malnutrition or even just being underweight,” Bloomquist says.

After Cindy Finnesy, RHIT, CCS, of Newton (KS) Medical Center, read the recent Coding Clinic guidance, she and the HIM director decided their hospital should have a policy delineating when coders could use documentation from dietitians to code BMI.

“We just decided we needed a process for coders to know for sure what to do,” says Finnesy, the assistant HIM director and lead coder at the 103-bed facility. Newton’s policy states that coders will:

Select two appropriate codes when the BMI (documented by a dietitian or physician) and an associated diagnosis (documented by a physician) appear in the medical record
Query the physician in instances when an appropriately documented BMI of under 19 or higher than 40 appears without an associated diagnosis
The policy also states that Newton coders will not:

Code normal BMIs (i.e., 19–24.9).
Query when physicians document BMIs between 25 and 39.9 without an appropriate associated diagnosis. This is intended to prevent coders from overwhelming physicians with queries, Finnesy says.
Document BMIs for anyone under age 20.
Having a facility-specific policy for BMIs has helped create consistency and ensure compliant coding, says Finnesy.

Pressure ulcers
The ICD-9-CM Official Guidelines for Coding and Reporting and Coding Clinic, fourth quarter 2008, also offered guidance about pressure ulcer coding. Coders can assign pressure ulcer stage codes based on documentation from a clinician who is not the patient’s provider (e.g., a nurse). However, the patient’s physician must provide information about the pressure ulcer site.

“It was a logical place to allow a little bit of leniency,” McCall says. “Nurses are … adept at being able to identify the various stages of a pressure ulcer.”

For example, wound care nurses have more experience treating pressure ulcers than do other nurses and physicians, Bloomquist says. Also, during treatment, they more closely measure and monitor an ulcer, documenting its depth and taking pictures to watch its progress.

Although the guidance makes the overall process of coding pressure ulcers slightly easier, it doesn’t prevent the need for physician queries. The official guidelines explicitly delineate a sequence for coding this condition: First, select a site code from diagnosis code range 707.00–707.09. Then select a stage code from diagnosis code range 707.20–707.25. When the physician doesn’t document a site, a coder cannot assign either code.

Codes for pressure ulcers, BMI
Guidance in the ICD-9-CM Official Guidelines for Coding and Reporting and Coding Clinic, fourth quarter 2008, that took effect on October 1, 2008, stated that coders can use documentation from nonphysicians to code pressure ulcer stage and body mass index (BMI). Following are the relevant codes:

Pressure ulcer site

707.00, unspecified site
707.01, elbow
707.02, upper back
707.03, lower back
707.04, hip
707.05, buttock
707.06, ankle
707.07, heel
707.09, other site
Pressure ulcer stage

707.20, unspecified stage
707.21, stage 1
707.22, stage 2
707.23, stage 3
707.24, stage 4
707.25, unstageable
Body mass index

V85.0, BMI less than 19, adult
V85.1, BMI of 19–24, adult
V85.2x, BMI of 25–29, adult
V85.3x, BMI of 30–39, adult
V85.4, BMI of 40 and higher, adult
V85.5x, BMI, pediatric
Editor’s note: DeAnne W. Bloomquist, RHIT, CCS, is the president and chief consultant at Mid-Continent Coding, Inc., in Overland Park, KS. E-mail her at

Shannon E. McCall, RHIA, CCS, CPC-I, is the director of HIM and coding at HCPro, Inc., in Chesterfield, VA, and veteran instructor of HCPro’s Certified Coder Book Camp®–Inpatient and Original versions. E-mail her at

Cindy Finnesy, RHIT, CCS, is the assistant HIM director and lead coder at Newton (KS) Medical Center.

This story originally appeared in the March issue of Briefings on Coding Compliance Strategies.

Registered/Certified Coder

Posted 2 days ago

Robert Wood Johnson, New Brunswick, NJ
Job Summary


Robert Wood Johnson University Hospital, the 584 bed primary teaching hospital of UMDNJ Robert Wood Johnson Medical School, is currently seeking experienced Certified Clinical Coders to work in our Health Information Management Department.

Qualified candidates must have a minimum of 5 years strong working knowledge of inpatient coding. Candidates must have thorough working knowledge of MS-DRG reimbursement methodologies, ICD9-CM coding, encoding software and computer skills. Candidates must have work experience in an acute care setting, preferably in a teaching hospital environment and must possess CCS credentials.

Send resume with salary expectations to:
Human Resources Fax: 732-937-8730
Or apply online

181 Somerset St., New Brunswick, NJ 08901

Equal Opportunity Employer

Perdue announces new training programs

By Rob Christensen – Staff Writer
Published: Thu, Apr. 16, 2009 12:39PMModified Thu, Apr. 16, 2009 12:42PM
Gov. Beverly Perdue this morning announced a new program designed to quickly retrain people for jobs where are shortages.

At a news conference at WakeMed, Perdue said she would use $13.4 million in federal stimulus money to start accelerated six-month training programs for 12 occupations. She called it “12 in 6.”

“We know that people who have lost their jobs need to get back in the work force as quickly as possible,” Perdue said. “This rapid training initiative provides them with a clear path to success in new, sustainable careers.”

The 12 areas are nursing assistants, phlebotomy, medical coding, office/clerical support, masonry/tile cutting, plumbing, carpentry, welding, food service, auto body repair, manufacturing/materials and HVAC/industrial maintenance.

The new initiative comes at a time when North Carolina is experiencing double digit unemployment.

The program will be run by the state community college system. Scott Ralls, the community college president and Keith Crisco, the state commerce secretary attended the news conference.

The new training will begin in September. The state community college board is scheduled to vote on the program on Friday.

Software Driven Documentation of Medical Necessity Alleviates Compensation and Compliance Issues for Chiropractors: ACOM Chief Software Engineer Vais Salikhov

ATLANTA, Georgia, April 16, 2009 – The ramifications of poorly coded documentation can be severe for any doctor and particularly for chiropractors, affecting their compensation for services and raising the potential for legal or regulatory issues. Even so, many practitioners considering the implementation of electronic medical billing and record keeping at their clinics remain unaware that software solutions with on-board coding and compliance protection currently exist, according to Vais Salikhov, Chief Software Engineer at the Healthcare Division of ACOM Solutions, Inc.

“The name of the game is medical necessity, and chiropractors are an easy target,” Salikhov said. “Most are not well-schooled in coding and documenting medical necessity nor in the legalities of compliance, and both are fundamental to getting paid properly and ethically so as not to run afoul of professional and regulatory agencies. But in the absence of formal education in the use of CPT and ICD-9 codes, doctors can risk making unfounded judgments that can create problems for them.”

“Well-designed chiropractic software is no substitute for formal training, but it can provide doctors with a back-up resource that enforces concise coding and clarity of documentation, both of which assure better and more consistent compensation and alleviate compliance issues.”

ACOM’s RAPID Chiropractic Software accomplishes this by electronically linking the activities documented in examination and treatment rooms with the business activities of the front office, notably billing and collections, Salikhov said.

Reviewing the patient’s self-described condition, doctors perform a detailed exam guided by the tablet computer-resident software, noting each symptom by means of interactive graphical diagrams or check-lists. Each of these helpers is associated with structured and tested but customizable text that becomes part of the patient record. RAPID then links the treatments prescribed to the findings of the exam, forcing the validation of medical necessity. It provides a similar level of support throughout the recovery process and before claims are submitted, it automatically checks charges to assure that all services are accounted for and billed accurately.

“Not only does this help insulate the doctor from insurer and regulatory hassles, but it also has a positive effect,” Salikhov noted. “Checking the charges challenges the doctor to confirm that he/she has billed completely and accurately for all of the work performed and that it has been properly coded and documented.”

About ACOM Health Division
The ACOM Health Division serves chiropractic and the broader healthcare community with products and services that enhance efficiency, cut costs, increase revenues and propel practice success. ACOM’s RAPID software suite simplifies and speeds clinical notes and reporting while supporting compliance, collections and front office operations.

For more information:
-Call: 866-286-5315
-Visit: Contact Information

Workshop aims to increase access to medical care for senior citizens

Debbie Bell
The Daily Record

Local physicians who take a few hours out of their busy schedules for a workshop this Thursday will benefit by becoming Medicare experts.

“It’s worth taking the time to show up and participate,” said Holly LeMaster, needs assessment coordinator for the project, which is sponsored by the Colorado Medicare Experts/Senior Access through a grant from the Colorado Health Foundation. “We know physicians have really busy practices, but this is an amazing gift from the Colorado Health Foundation.”

The free workshop is intended to increase access to medical care for Colorado seniors. Sessions include Medicare documentation and coding, clinical guidelines and Alzheimer’s Association services. Dinner will be served to participants at no charge.

“Our philosophy is a lot of primary care doctors don’t feel they get paid appropriately by the Medicare system,” LeMaster said. “It takes a lot of time to care for seniors. We’re teaching some of the lessons that have been learned the hard way by Senior Care of Colorado, P.C.”

Senior Care is a Medicare-only private practice located throughout the Denver metro area. A total of 60 providers now participate in the organization that was founded in 2001 and now is one of the largest privately-owned primary care geriatric practices in the country.

The MESA training workshop will be taught by Dr. Mike Wasserman, a practicing board-certified Geriatrician and co-founder of Senior Care of Colorado.

“The workshops are being taught by the doctors who are the co-founders, so that’s a unique thing,” LeMaster said. “It’s a physician-to-physician program. These doctors want to take what they know and help other doctors be successful with Medicare.”

The Colorado Chapter Alzheimer’s Association is working with the program to provide a clinical dimension to the workshop.

“If a doctor can be comfortable dealing with a patient who has Alzheimer’s or related dementia, then that doctor probably will be comfortable dealing with any senior,” LeMaster said.

The workshops eventually will be offered throughout three regions of Colorado, but Colorado MESA is starting with the Pueblo area, including Cañon City.

“Workshops are coming up throughout this region, then we’ll focus on the Northeast region and also the Grand Junction area,” LeMaster said.

The workshop is offered to physician practice leaders/owners; physicians, nurse practitioners, physician assistants and registered nurses who care for seniors; practice administrators and managers; and billing office personnel.

The free workshop will begin at 5 p.m. Thursday at St. Thomas More Hospital Community Education Room. For reservations or more information, call LeMaster at (720) 855-8133 or e-mail

Reservations are accepted for the workshop but are not required. LeMaster said reservations primarily are used to ensure dinner for everyone who attends. Alternate workshop dates are offered throughout the Pueblo region from now through June for anyone interested but unable to attend Thursday.

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