The July 2015 Q&A Medical Coding Webinar from Certification Coaching Org (CCO), www.cco.us, discussed a variety of topics of interest to outpatient and inpatient medical coders. Topics included Conversion of Dx codes to DRGs, Auditing Question, Fracture Coding, ICD-10 Initial Encounter vs. Subsequent, Rule of 9’s, Back to Basics – Coding Contrast, Transbronchial Biopsy, and Coronary Arteries. Certification Coaching Org’s product offerings, the CCO Replay Club which allows members to review past monthly webinars and obtain CEUs, and Certification Coaching Org’s CEU offerings were also discussed. Attendees’ questions on various coding topics were answered. Educational topics were presented by Tammy Lucus, CIC, CPC, COC, CPC-I, CPMA; Alicia Scott, CPC, CPC-I, CRC; and Laureen Jandroep, CPC, CPC-H, CPC-I, CMSCS, CHCI, CPPM. The host for the webinar was Boyd Staszewski.

1. Certification Coaching
Q & A Webinar- July 2015

2. First Webinar With Us?
Poll
How many CCO webinars
have you attended?

3. This Month’s Q and A Webinar Agenda: 90-120 min
II: Q&A from our Instructors
● Tammy: Conversion of dx codes to DRGs
● Tammy: Auditing Question
● Alicia: Fracture Coding
● Alicia: ICD-10 initial encounter vs. subsequent
● Alicia: Struggling with Rule of 9's
● Laureen: Back to Basics - Coding Contrast
● Laureen: Transbronchial Biopsy
● Laureen: Coronary Arteries
I: Introduction
● Why stay?
● Recent CCO Graduates/ You Too?
● Announcements and Course Updates
IV: Your Questions in the Chat
Ask Along the way in the Questions box
If your question isn’t selected, post it on our forum
where fellow coders can help:
http://www.cco.us/forum/
III: Close - @ 90 min-’ish’
● Wrapup
● Drawing
● CEU Certificate Download

4. Poll
Poll - What
region of the
country are
you from?

5. Why Stay To The End?
Giveaway!
Free Drawing of Your Choice of 1 of the following:
Blitz Video Package | 2 CEU Webinars | 1 Hour Session with Laureen or Alicia
and...
Your AAPC CEU link for 1.5 CEUs

6. CCO Congratulations to Recent Graduates!
Recent and You’re Not Here? >> Type in the Questions Box | Certification/Date
Patricia Rathbun 6/19/2015 Passed CPMA
Valerie Fehlman 6/19/2015 Passed CPC
Tricia Allen 6/13/2015 Passed CPC
Kate Balduff 6/1/2015 Passed CPC
Sandra Marroquin 6 / 2015 Passed CPC
Faith Wiegman 6/22/2015 Passed CPC
Jeanne Muller 6/20/2015 Passed CPC
Nancy Zizelman 6/20/2015 Passed CPC
Cheryl Cormier 6/24/2015 Passed CPC

7. More Congratulations to...
Shelly Thurgood 7/17/2015 Passed CPC
Melissa Barnard 6/27/2015 Passed CPC
Shannon Froning 7/11/2015 Passed CPC
Robin Thompson 6/15/2015 Passed CPC
Susan John 6/29/2015 Passed CPC
Mary Herter 6/30/2015 Passed CPC
Fereshta Porooshasp 6/20/2015 Passed CPC
Anna Vinchkoski 6/20/2015 Passed CPC

8. More Congratulations to...
Jennifer Haduck 6/27/2015 Passed CPC +
Jennifer Haduck 7/7/2015 Passed ICD-10 Assessment
Sandra Bowers 4/18/2015 Passed ICD-10 Assessment
Jen Fowler 7/1/2015 Passed ICD-10 Assessment
Lori Holtzinger 7/5/2015 Passed ICD-10 Assessment
Everett Barker 7/8/2015 Passed ICD-10 Assessment
Charlotte McLaughlin 7/12/2015 Passed ICD-10 Assessment
Lori Conley 6/23/2015 Passed CCO PBC
Marilou Yu 6/16/2015 Got a J-O-B !!

9. ICD-10-CM Official Guidelines for Coding & Reporting
ATTENTION:
FY 2015 - NEW CHANGES NOW POSTED
http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2015.pdf
How to read the document:
● FY 2015 Narrative changes appear in bold text
● Items underlined have been moved within the guidelines since the FY 2014
● Italics are used to indicate revisions to heading changes

10. ● ICD-10-CM Blitz - new!
○ Prepare to pass the Proficiency Assessment exam with ease!!
○ 16 hour course equivalent
● ICD-10-CM Full Course **Payment Plan Now Available**
○ 80 hour course equivalent
○ using “Understanding ICD-10-CM” text by Bowie
● ICD-10-CM Practice Exams
○ Free 25 Question Exam
○ Paid 50 Question Exam - $29.95
The Future of Coding >> ICD-10 Prep - CCO Style

11. Remote Presentations
ATTENTION:
Do you need a speaker at an upcoming
event or meeting?
Here we are >>
Alicia Scott
CPC, CPC-I, CRC
Laureen Jandroep
CPC, CPC-I, COC, CMSCS, CHCI, CPPM

12. How to Become a Certified Medical Coder or a Medical
Biller
Without The Staggering Costs of Traditional Local Schools
http://go.cco.us/medical-coding-billing-course-bundle
Full MCB - educational coding and
billing
bundle package for:
$2475
SUMMER SPECIAL >>> MCB Bundle

13. Here's a recap of everything you'll receive when you secure your copy:
The CCO Medical Coding and Billing Training Package- MCB
Essential coursework to become a medical coder or medical biller- $1000.00
Individualized plan created just for you- $1000.00
Personal coach included- $1000.00
Weekly support calls with students and coaches- $1000.00
Practice Exams- $69.95 *
http://go.cco.us/medical-coding-billing-course-bundle
SUMMER SPECIAL >>> MCB Bundle

14. And You're also Getting:
6 extra months of access to all courses and coaching: 18 months total - $500.00
Replay club access for 1 year - $240.00
CCO CEU Club access for 1 year - $240.00 *
CPC Blitz for 1 year - $197.00 *
ICD-10 Blitz for 1 year - $395.00 *
6 month Payment Plan Available
* Bonus items marked are accessible upon completion of the payment plan
SUMMER SPECIAL >>> MCB Bundle

15. Poll
Poll - What AAPC coding
credential do you HAVE?

16. ● Tammy: Conversion of dx codes to DRGs
● Tammy: Auditing Question
● Alicia: Fracture Coding
● Alicia: ICD-10 initial encounter vs. subsequent
● Alicia: Struggling with Rule of 9's
● Laureen: Back to Basics - Coding Contrast
● Laureen: Transbronchial Biopsy
● Laureen: Coronary Arteries
Coding Q and A | July 2015

17. Conversion of dx Codes To DRGs
Question:
How do I convert dx codes into DRGs?
ANSWER

18. Auditing Question
Question: Is there any way I can get some insight on an audit situation?
Established patient came in for an earache. History documented was
comprehensive. Exam was EPF. In the MDM, this was new problem to
provider, with no additional work up planned, which is 3 points. The
complexity and data reviewed is minimal. No lab, x-rays ordered. The risk
was moderate. There was a prescription wrote for the ear. This is sort of a
gray area. The presenting problem is straightforward, but the documentation
supports moderate medical decision making. Should this be a 99212 or
99213, using exam and mdm as the components for choosing the level?
ANSWER

19. Poll
Poll - What coding credential
do you WANT?

20. ICD-10 Initial Encounter vs. Subsequent
Question: If a patient had an injury and went to the ER for
initial treatment and sutures were placed. When they
come to our office for suture removal would that be an
initial encounter as it is the first time at our office with this
diagnosis? or would it be subsequent?
ANSWER

21. Poll
Are you ICD-10
Proficient?

22. Question: I am looking for help in fracture coding. Is
there a good webinar? Suggestions?
ANSWER
Fracture Coding

23. The Rule of Nine’s
Question: I am struggling with the Rule of 9’s. Can you
explain burn coding from and ICD and CPT perspective?
ANSWER

24. I saw a YouTube clip of you explaining the administration of contrast
and made it look much easier with the chart. I'm unable to locate it at
the web address on the slide. Is this chart still available?
I'm studying for my CPC and I'm finding the youtube clips very helpful.
I'm a verbal learner and appreciate this resource.
ANSWER
Back to Basics - Coding Contrast

25. Transbronchial Biopsy
Question: How would you code a transbronchial biopsy
of the left lower lobe of the lung with BAL washings, but
with no lung tissue identified on the pathology report?
ANSWER

26. Coronary Arteries
Question: I am Confused with major coronary arteries questions.
Can you give an example of questions with the answer as 92933-RC,
92934-LD.
One of the practice exam questions gave an example of question
with an answer : 92933-RC, 92933-LD. I need more clarification on
how to answer correctly the questions from major coronary arteries.
ANSWER

27. COURSES
★ Medical Terminology & Anatomy Course (MTA)
★ Physician Based Coding Course (PBC) - (CPC course)
★ Facility Based Medical Coding (FBC) - (COC course)
★ ICD-10-CM Course
★ ICD-10-PCS Course
★ Medical Billing Course (PBB)
★ Medical Coding Auditing Course (PBMA)
★ Physician Practice Management Course (PPM)
★ HCC Risk Adjustment Course
★ Medical Coding Practicum (MCP) Course with
Practicode
Quick Lineup of CCO Courses
Reviews & Mock Exams
★ CPC Exam Review Blitz Package
★ CPC Mini-Mock Practice Exams
★ ICD-10-CM Blitz Package
★ ICD-10-CM Mini-Mock Practice Exams
For full listing see:
cco.us/Products

28. “I passed my CPC (test 6/13) on the first try.…. I know the Blitz is what really helped me to
pass. The video's were great, notes for CPT book were incredible, I am older so I got
Laureen's jokes, and of course the bubble and highlight…. On all practice tests I was able
to finish before the time and each one improved my score. When the real test came I
finished in 4 1/2 hours which left me with time to review.
Thank you all so much for the help and the great webinars. Well off to work on ICD-10
test … and then take some time off before I start on my next certification (not sure which
one yet but I know I will be coming thru CCO for it).” Tricia A. 6/19/2015
What are our Student saying?
Testimonials
Tricia was sad she missed sending to our last webinar (by one day), so we decided
to highlight her!

29. Medical Terminology & Anatomy Course (MTA) 40 CEUs!
CEU Classes (On Demand) ranging from 1 - 4 CEUs each
ICD-10-CM Blitz Course (ICD-10 CM Proficiency Assessment) 16 CEUs!
ICD-10-CM Full Course 40 CEUs!
Facility Based Coding Course (FBC) 40 CEUs!
Physician Practice Manager (PPM) 6.5 CEUs!
Physician Based Billing Course (PBB) 18.5 CEUs!
Physician Based Medical Auditing (PBMA) 12.5 CEUs!
http://cco.us/products
Looking to Fulfill your CEU Requirement?
More CEUs from CCO!

30. WEBINAR CEU's - REPLAY CLUB
Monthly CCO Webinars:
● * Worth 1 to 1.5 CEU per meeting
Replay Club:
● * up to 12 free CEUs (or more) per year
● (for indicated Webinars)
- Regular Attendees
- Replay Club Members
http://go.cco.us/webinar-replay-club

31. LIKE us on Facebook
http://facebook.com/cco.us
Help Us Get The Word Out

32. www.YouTube.com/MedicalCodingCert

33. Blitz Video
Package
or
2 CEU
Webinars
or
1 Hour
Session with
Laureen
(or Alicia)
Free Drawing! Your Choice of:
Pick Winner

34. ”CCO Swag - Pay it Forward” Program
http://www.cafepress.com/CCOSwag
CCO-BRAND SPECIALTY STORE
Here is where CCO wants to partner with YOU so we can all
“Pay it Forward”.
The profit from all CCO Swag purchases will go into a
scholarship fund for worthy students trying to afford CCO
courses in their quest to enter the profession.
You can purchase at the store now.

35. If you don’t already receive our
newsletter, send a message to
helpdesk.cco.us
request to join ‘The Insider’s Club’
(Send from the email address you
wish to receive your newsletter)
Join the “CCO Insider’s Club”
Monthly Newsletter
Monthly articles by Laureen -- she
wants you to be ‘In the Know’
‘Snidbits’ by Alicia
● Timely Industry Announcements
● The Course Corner
● Remote Seminar Partners
● Congratulations to our Grads!
● Testimonials - what are people saying?
● Current Blog links
Get Access to Our Best Free Medical Coding
and Reimbursement Resources!

36. Questions In The Chat
ANSWERS

37. Links Referenced in the Webinar
MCB Bundle - http://go.cco.us/medical-coding-billing-course-bundle
Administration of Contrast Chart - http://www.cco.us/administration-of-contrast
Bronchoscopic Alveolar Lavage (BAL) - http://www.olympus-
me.com/medical/en/medical_systems/applications/pulmonology/diagnostic_bronch
oscopy/bronchoscopic_alveolar_lavage__bal_/bronchoscopic_alveolar_lavage__b
al_.html
PCI Coding Forum Post - http://www.cco.us/forum/threads/major-coronary-
arteries.2871/

38. Links from Alicia’s slides
http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_201
5.pdf
http://www.symbiosisrcm.com/understanding-burn-codes-
just-made-easy/
http://my.firefighternation.com/forum/topics/889755:Topic:

39. Links from Laureen’s slides
http://www.cco.us/administration-of-contrast
http://www.olympus-me.com
http://www.findacode.com/code.php?set=CPT&c=31624
http://www.cco.us/forum/threads/major-coronary-
arteries.2871/

40. Chat Q & A
Webinar- July 2015

41. CCs, CIC/COC?
Most of the job openings that I see are for ancillary
positions. Do you think it's better to get the CCS (which is
what most of the entities ask for) or the CIC/COC?

42. CCS or CPC
Can you please talk a little about taking the CCS
examination through AHIMA versus the CPC examination
through AAPC. I have my CCA, but since finding CCO, I
am thinking I should change direction and go for the CPC.
Please advise...

43. CPC before CPB?
I am leaning toward billing. Would it be better to take CPC
first before CPB?

44. Guidelines ICD9/10 and CPT
What is the best way to learn the guidelines in ICD9, and CPT I know
there are parathencial notes help. Any advice would be helpful.
Can you explain to me the difference between the CPT and the ICD-
10 Coding?? Thank you!!

45. E&M Level
Is there a short cut to determining the level of care for
E&M codes from a scenario that does not give the level of
hx, exam and mdm?

46. HMO and Medicare
If pt. has HMO plan as primary and Medicare as
secondary, and the provider is not participating with HMO
plan, but is a Medicare provider, can I bill Medicare?

47. Burns
Alicia on the Lund Brower Diagram do you add the total
numbers together to get the percentage of the burn?
If a patient is re-admitted for additional skin grafting for a
non-healing burn, is the ICD-9 coded as a non-healing
wound or a burn?

48. ICD-10 Diabetes
Alicia, ICD-10 guidelines state that if the TYPE of
diabetes is not documented then the default is Type 2
DM. Does this guideline apply to a patient that is
pregnant? Or would you code UNSPECIFIED diabetes in
pregnancy instead of Type 2 diabetes in pregnancy when
the type is not documented? We run into ER patients
who are pregnancy with a past history of "diabetes".
Thank you!

49. HCPCS for BLS Emergency
What HCPCS code is reported for BLS emergency
ambulance service for an automobile accident victim from
the accident to the hospital, when the ambulance starts
out from the hospital? The rationale said that the
Ambulance Modifiers are in the front of the Ambulance
section and I simply don't see them. Help! Thank you!

50. Thanks For Being With Us!