Career Step, LLC. Spring 2011

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

Here We Grow Again! . . . . . 2

Graduates . . . . . . . . . . . . . . . 3

AAPC and AHIMA News . . 3

Student Spotlight . . . . . . . . 4

Dear Cari . . . . . . . . . . . . . . . . 5

MedicalCODING

Bulletin

Spring Cleaning: Tackling the Junk Drawer

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The Junk Drawer. We all have one somewhere. Whether it contains old

keys, pens, papers, receipts, magnets, matches, a few chip clips, some plastic bags, buttons or a few things that are broken, there’s likely a drawer, cupboard, or space in your home, your car, your purse, or your desk at work you’d like to be more organized.

The problem with the junk drawer is that it didn’t start out that way. It usually begins as a few items we tend to file “sometime soon” or something we are going to “get around to” sometime in the future. Really, it’s a temporary holding space for our unrealized goals and ambitions. We add one thing at a time, and it doesn’t seem like much until one day we pull open the drawer and realize that the mess now looks overwhelming and that it’s impossible to handle. For this reason, I want to propose that organization and time management are not two separate skills. Rather, they are one and the same. Time management simply means the organization of one of our greatest assets—our time!

Time Management effectively helps us to organize, prioritize, and keep on schedule—all of which are absolutely essential to have at every stage of pursuing a career in medical coding.

As a StudentHow does it come into play as a student? When students enroll in an independent study program, a year seems like a long time. A little break here and there won’t seem to make much of a difference at the time, but those small delays are like slowly adding things to your junk drawer. Many times students come close to their expiration date and they open up the drawer only to realize they have fallen more behind than they intended to and now are realizing it will be impossible to finish by their end date. If you have a goal to complete the program without purchasing an extension, you need to plan your time well along the way. Interruptions will happen on a daily basis, and setbacks may occur; however, with an organized plan and dedication to your goals, you can stay on task with your studies.

Use the Study Planner feature in your program to create an outline for yourself, track your progress, and keep on schedule. Then set a routine and make sure those around you know what that routine is. Plan how many hours a day you will spend on your program, and stick to it! Be aware of what types of things are preventing you from keeping that routine and work to avoid those distractions.

As a Job-SeekerSo you’ve graduated. Phew! You’ve accomplished getting through the program and as challenging as it can sometimes be to stay motivated and keep on schedule, you’ve successfully

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Continued from pg 1made it! Now, you’re facing the job market and ready to apply the skills you’ve learned to find a job as a medical coder. Good thing we don’t need that time management and organization anymore, right? Think again.

As a job seeker, organization and time management are essential! Looking for a new position can be a full-time job in itself, and if you’re not careful, you can quickly create a junk drawer full of sent resumes, employer names, dates, and information that becomes impossible to track.

Trust me—you don’t want to have the experience of finally getting that call back and getting flustered as you search for information: “I’ve applied to 25 employers in the last two days—who is this? What position is this for again?” That doesn’t leave a good impression with a potential employer, and it’s not the way you want to begin an interview or a contact over the phone!

One great tip to help you avoid this, get organized, and effectively manage all your applications is to keep a record as you go. Each time you apply, record any important information that you find—the employer name, the date you applied, how you applied (via email, contacted by phone, visited in person, filled out an application online), and other important information such as job descriptions, contact information, phone numbers, addresses, etc. Keep that

information in a folder or in a Microsoft Word document. As you keep record of this information, you will be more effective in promptly following up and locating information that you need at the time you need it—both of which will help you to be more successful in your job search.

As a Working CoderNow you’ve found your job. You’re on your way in your career, and time management and organization are still very important. Every day coders are faced with a work load and they must effectively prioritize their time and resources.

You come into work and have all the discharges from the day before in front of you. You have to prioritize those so that you’ll finish them by the end of the day, but you still have a few reports left over from the previous day. You have another folder for records for which you’ve submitted a physician query and are awaiting feedback, and during the course of the day you’ll probably come across a few more complicated procedures that will take a little extra research. Sometime during all that, you’ve got to find time to train a new employee as you’re also heading up a project to aid in your facilities’ conversion of the records from paper records to EHRs. You’ve got to be completely finished with everything by 4:30pm because you needed some extra time to gather some materials to prepare for the AAPC chapter meeting that will be held that night right after work.

There isn’t any room for procrastination when you have records and reports rolling in and a physician or billing department waiting on you for the reimbursement process to move forward. You will be asked to complete additional and unplanned projects and you will come across unexpected delays. You might need to track down information and individuals throughout your day as well, and you certainly need to be able to manage your own time.

Your employer will expect accuracy and efficiency. Often employers will have those expectations clearly identified, and if you’re not meeting those performance levels by a certain point, and on an ongoing basis, you will be back to organizing your time as a job seeker.

We all have limited time and lots of responsibilities. The earlier you develop the skill to effectively organize your time, the more you will find that you can organize every other aspect of your life, leaving you a sense of calm reassurance that things are in order, and under control.

…And you won’t have to worry about someone inadvertently discovering that junk drawer you hoped no one would ever see!

- Jenae WalkerCS Coding Support

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Here We Grow Again!New Career Step Programs

As of March 1st, Career Step is offer-ing a new training opportunity—the

Administrative Assistant program!

Administrative assistants play an impor-tant role in a wide variety of industries, and these professionals are crucial to keeping many offices running smoothly. The U.S. Department of Labor reports that this occupation employs over 4 mil-

lion professionals, making it one of the largest in the nation. They also estimate that employment in this field will grow by 11% by 2018, which equates to over 471,000 new jobs!

Administrative assistants can be found working in schools, government agen-cies, and corporate settings across a broad range of industries. Job opportuni-

ties are expected to be especially high for those who have a strong background in computer software applications. The program covers computer fundamentals, beginning through advanced training on Microsoft Word, Excel, Outlook, and Power point, business writing, office pro-cedures, and more. As with Career Step’s other training programs you have access

MEDICAL CODING BULLETIN Spring 2011 3

GRADUATESLaurie Bland – Spring Valley, IL It is my pleasure to comment on my graduation. I am very pleased with the Medical Coding and Billing course I took through Career Step. This course is very challenging and very rewarding. You learn so much more than Medical Coding and Billing. The forums, chat rooms, consultations, and support staff are very helpful. If there is something you do not understand or something you need help with, they are there to assist you. Upon graduation of the course, there is a consultation for graduation that is very informative in assisting you with your resume, interviewing for a job, and providing lists of job openings in your area. This course does take time and effort to complete, but when you have finished your final exam and receive your diploma, you can reflect on all of the new knowledge you have acquired and look forward to your career as a Medical Coder. Happy coding everyone.

Vanessa Costa – Clarksburg, WVCareer Step changed everything for me! The program was challenging, and ultimately rewarding! I went on to become nationally certified, soon after completing the course. The staff is the best, and Randy was especially helpful! Thank you for the new career and life!

Rachel Cornett – Sandia Parks, NMAs a recent graduate of Career Step’s Inpatient and Outpatient Coding Program, I couldn’t be happier with my educational experience. The program fit my needs extremely well. I was working full-time during the process, so the self-paced manner of the course was a huge part of my success. The course most definitely provides you with the knowledge you need to successfully pass one of the national coding exams with AHIMA or AAPC. I sat for the CPC exam and it was very similar to the Career Step final. I passed the exam magna cum laude with a score of 90%, which I know is largely (if not entirely) due to the quality of training I

received through Career Step. The Career Step staff was friendly and answered my questions thoroughly and promptly. I feel lucky to have found such a comprehensive, well-respected program, and am excited to begin working as a coder.

Patricia Lundell – Arlington Heights, ILMy experience with everyone at Career Step has been exceptional! All questions are answered in a timely manner and explained thoroughly. Also Randy Johnson is an asset to your team. He is friendly, and professional at all times. Randy will answer a question as many times as needed until the student understands. At this time I am studying to take the CPC at the end of March and am quite excited. I look forward to starting a career in the medical field.

Adam – Payson, UTBernadine – Roxboro, NC Brooke – Denver, COChad – Yankton, SDCheryl – Hayward, CAChristina – Maple Valley, WA Connie – Fayetteville, NCCora – Newport News, VADava – Spring Valley, ILDawn – Reading, PAErin – Harlingen, TXErin – Acworth, GAEugenia – Garden City, KSHuethuy – Aurora, COJanet – Hampton, VA

Jeanann – Fayetteville, NCJeanette – Denver, COJennifer – Virginia Beach, VAJulie – Fargo, NDKaren – Fayetteville, NCKatie – Ottawa, ILKim – Kernersville, NCKimberly – Belvidere, ILKimberly – Longview, TXKimberly – Bruceton Mills, WVLaurie – Warren, OHLaurie – Spring Valley, ILLizabeth – Princeton, ILLori – Trent, SDLori – Bandon, OR

Lucinda – Tucson, AZMaria – Springfield, MOMarisa – West Chazy, NYNikki – Tonica, ILOlena – Omaha, NEPaige – Ottawa, ILPatricia – Arlington Heights, ILPenny – Indian Land, SCRachel – Sandia Parks, NMRoya – Lakewood, COSandra – Virginia Beach, VASharon – Ottawa, IlTami – Tampa, FLYehudis – Baltimore, MD

AAPC and AHIMA New Years “New”sNew Certification Exams and New Books: AAPCOn January 1, 2011, AAPC released their updated CPC exam to reflect the code changes of 2011.

AAPC’s current policy requires you to have either the current or past years’ code books in order to be eligible to sit for the CPC exam. During 2011, you will need to have either the 2010 or 2011 ICD-9, CPT, and HCPCS books in order to sit for the exam. As the exam was updated on January 1, 2011, you will be at a slight disadvantage with the 2010

versions, and AAPC recommends that you have the 2011 books if you take the exam this year.

AHIMAOn March 31, 2011, AHIMA released their updated CCA exam to reflect the code changes of 2011. Beginning on that day, you will need to have 2011 editions of your code books in order to be eligible to sit for that national certification exam.

New Exam Testing Centers:AHIMABeginning this year AHIMA made the switch from using Prometric testing

centers to Pearson Vue testing centers as locations for taking the CCA exam. To find a location near you offering the CCA exam:

Visit http://www.pearsonvue.comClick on Locate-Find a Testing CenterScroll down on the right side to select American Health Information Manage-ment Association (AHIMA) and click on it. Select your country/city/state or zip code and hit Search.

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Student in the Spotlight -Vivian Tirabassi

I was born and raised on the east coast, in a fishing village on the water. I spent

many idyllic summers lazing on the beach. After college, I married and had three wonderful children, and then we moved to the southern part of the United States where I worked in health care.

My husband died suddenly, leaving me the sole support of my family. But having been a nurse for many years, and having endured the long hours, working nights, weekends and holidays, and the unreasonable work demands, I wanted to change careers. I still wanted to stay in the healthcare field, so when I discovered that Career Step offered an online Medical Coding program I decided to

investigate further. A good friend of mine had been a medical coder and loved it, so I thought I would give it a try. Also, I found the cost of the program was much less than other comparable ones. When I began the course, I found that even though the price was less, the content was not. It was quite rigorous. Even though as a nurse I was required to know medical terminology as well as anatomy and physiology, I found the program quite challenging. It was extremely thorough training in this area, which would be a very important part of medical coding. One has to be very familiar with medical terms and parts of the body to be able to code efficiently. Once I was in the program I found it a challenge to balance working along with taking care of three children. As a single parent, I had to work hard to find a good, workable schedule to study the modules. I set aside a time each day

after work (and sometimes would sneak a few minutes before work) to go over the material. I would study an hour a day and a few hours a day on the weekends. Budgeting my time was crucial because I didn’t want to ignore my children. Sometimes I actually got them to help me by using the flash cards that I made. They held up the cards and got a kick out of it when I got the words wrong! It made them feel important to help me! It was fun. One thing I love is the discussion forum where you can post comments or questions. Usually someone will come up with an answer. I also like that there is a hotline you can call to get individual help. I hope to finish soon and enter the medical coding world! I can hardly wait to explore the job possibilities for my new career!

- Vivian Tirabassi

to Student Support and Graduate Sup-port every step of the way to help you be successful. With Career Step’s program you can prepare for a promising career in as little as 2 months! In your training you will also be eligible to earn a Microsoft Office Specialist Master credential. Please call 1-200-411-7073 or visit www.career-step.com for more information.

Medical Administrative AssistantAlso newly available is Step’s Medical Ad-ministrative Assistant program. This train-ing prepares you to take the National Healthcareer Association (NHA) Certified Medical Administrative Assistant (CMAA) exam and start your career as a medical administrative assistant. In this program you learn how to successfully run the front office operations of a medical facility, including front desk reception, patient scheduling, billing, and practice finances. The program is certified by the National Healthcareer Association (NHA) with potentioal positions working in doctors’ offices, dental offices, hospitals, outpatient clinics, insurance companies, and medical facilities; there are oppor-tunities in almost every community. The U.S. Department of Labor estimates that

the demand for medical administrative assistants will grown by 27% by 2018; that’s 125,000 new jobs! With Career Step’s program, you can be job-ready in as little as 3 months!

Additionally, training as a medical ad-ministrative assistant can open doors to other healthcare professions! Here are a few areas, which may require additional training.

Medical Records and Health Information Technician A medical records technician is the ruler of the medical records! As a medical records tech your job is to make sure all charts are complete and accurate. You also process any medical records requests by making sure all the appropri-ate release forms are signed, and copy the records that need to be sent. If a physician needs a chart or any informa-tion from a chart, it is your job to get the information to them.

Medical Assistant Medical assistants work with patients to determine the primary reason for their visit. They escort patients to the exam

rooms, take vitals, and ask questions relating to the patient’s symptoms or rea-son for the visit. Medical assistants also perform other medical procedures like EKGs, blood draws, urinalyses, and more.

Medical Transcriptionist Physicians dictate medical informa-tion and procedures for every office or hospital visit. These recordings must be transcribed into written form to establish the medical record. This is what medical transcriptionists do. Many medical tran-scriptionists work from home.

Medical Office Manager A medical office manager hires, trains, and schedules all employees an office. They may also work closely with the phy-sicians and back office employees. As an office manager it is your job to make sure that all areas of the office are running smoothly and all issues are taken care of.As you can see, a career as a medical administrative assistant could be the starting point for many other exciting opportunities in the future! For more information, call 1-800-411-7073 or visit our website at www.careerstep.com.

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MEDICAL CODING BULLETIN Spring 2011 5

Dear Cari... Jumbo-sized!Dear Cari,

I am trying to determine the ap-propriate level to assign for the Management Options element of the Table of Risk. Can you tell me the difference between sur-gery with identified risk factors and surgery without identified risk factors?

Sincerely,

- Wondering in Wisconsin

Dear Wondering,

Every procedure carries some sort of inherent risk and those will always need to be addressed with the patient by the provider. Since the Management Options element of the Table of Risk offer two choices—surgery (minor or major) with/without identified risk factors—there must be something else at work here beyond the typical discussion of risk held for every procedure. The identified risk factors are patient centered risk factors that put the patient at additional risk over and beyond what is inherent in the procedure itself.

“Risk factors are factors that increase a patient’s risk for harm. Some risk fac-tors are associated with the surgical procedure. Patient risk factors are those associated with the patient. Patient risk factors that are important are those that increase risk for postoperative infec-tion, excessive bleeding, and delayed healing.

The surgeon will determine risk factors based on the information given by the patient prior to any surgical procedure. Some important patient risk factors the physi-cian will want to know about include:

* tobacco use, especially long-term cigarette smoking* alcohol abuse or heavy drinking* obesity* malnutrition, including bulimia and anorexia* use of immunosuppressive drugs, including corticosteroids and chemo-therapy* use of herbal supplements* immunosuppressive disease—e.g.,

HIV-AIDS* diabetes or other chronic metabolic disease* chronic disease of the heart, liver, kid-neys, lungs or gastrointestinal system* chronic or recurrent skin infections such as boils* chronic or recurrent bacterial or viral

infections* medications that decrease the ability of the blood to clot, such as anti-inflammatory drugs* conditions that require an-tibiotics prophylaxes, such as artificial joints or valves”

I hope that sheds some light on the difference between surgery with and without identified risk factors.

Happy Coding!!

- Cari Greenwood, CCS, CPCCS Student Support Team

Dear Cari,

I was coding a report where the code for the procedure that was listed as having been performed second in the documentation was sequenced first in the coding. Why was it sequenced first when it was documented as having been performed after the procedure that was sequenced second?

Thanks,

- Puzzled in Pennsylvania

Dear Puzzled in Pennsylvania,

Thank you for your question. This is a common question that I often get from students.

The most important thing to remember is that the sequencing of procedure codes is not determined by the order in which the procedures are performed or listed in the documentation. This is based on the fact that the procedure code that is sequenced first represents the primary procedure.

The procedure code sequenced as the primary procedure should correspond to the most definitive, serious, complex, high-level procedure or the procedure that represents the greatest amount of risk. Generally, although not always,

the primary procedure is one that was performed to treat the primary diagnosis or the main reason for which the patient is being treated.

I hope this is helpful to you in making your future procedure code assignments.

- Cari Greenwood, CCS, CPCCS Student Support Team

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

MEDICAL CODING BULLETIN Spring 2011 6

AAPCAAPC continues to run their tests and exam dates through the local AAPC chapters.

To locate an exam site and test date for CPC:

Visit http://www.aapc.com/certification/cpc.aspx and click Locate/Schedule an Exam. Select your State and choose an exam location and date in your desired location.

New Networking Opportunities:AAPCAs part of your membership to AAPC, you become part of a local chapter. There are generally many local chapters within each state, and new chapters are created each year to support a growing popula-tion of networking coders.

To find your local AAPC chapter:

Click on this link: http://www.aapc.com/localchapters/find-local-chapter.aspxSelect your State, and then find the chapter that is in the city nearest to you. When you click details it should open up a webpage showing the contact information for the chapter officers and below that-- upcoming meeting times, exam dates, and dates to any additional chapter events.

Each year AAPC holds a national confer-ence, and this year it will take place in Long Beach, California from April 3rd-April 6th. For more information visit the AAPC website: http://www.aapc.com/medical-coding-education/conferences/national/longbeach/index.aspx

AHIMAAs part of your membership to AHIMA, you become part of your statewide as-

sociation. You can learn more about your component state organization by visit-ing: http://www.ahimafoundation.org/partners/csa.aspx

Each year, AHIMA holds a national con-vention, and this year it will take place in Salt Lake City, Utah on October 1st-Oc-tober 6th. For more information visit the AHIMA website: http://www.ahima.org/events/convention/default.aspx

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