Introduction to Coding Training

Basic training sessions are offered by request to orient employees in all departments to the coding process.  These sessions will be very basic in nature.  Our goal is to increase familiarity with the reference material used in coding and to reinforce the importance of choosing and entering into the billing system only the most accurate codes. If you have a faculty member that is interested, please let us know and we will be more than happy to schedule a more in depth individual session with that provider.

A description of each class is provided below to assist you in deciding who might benefit from attending these sessions.

Each person will need to bring the appropriate current CPT or ICD-9 book to that session so that we can give them some hands on training with these materials.

We offer these sessions based on our experience that knowledge of the coding process does encourage better accuracy.  We are always mindful of the increased scrutiny by payers that comes with our status as an academic setting.

Please call Marianne Fritts at 255-3409 if you are interested in basic training or have questions regarding the appropriateness of sessions for your specific staff, residents, or faculty. 


CLASS DESCRIPTIONS

CPT Basic Training

This session will explore the use of the CPT book and its instructions for making the appropriate code selections.

The CPT book provides a systematic listing and coding of procedures and services performed by our faculty members.  Each procedure of service is identified with a five-digit code.  This five-digit code is used to report procedures and services to payers.  It is critical to the billing process that the most accurate code is chosen to communicate the procedures and services provided.

Topics will likely include: The organization of the CPT book, why "close" is not good enough, how just finding a code does not guarantee reimbursement, the extra documentation requirements for unlisted codes, special instructions that may qualify the use of some codes, why your specialty section may not be the best place to find a code, and other resources when CPT is unclear.

A CPT manual is required for this session.


ICD-9-CM Basic Training

This session will introduce the organization of the ICD-9 book and briefly explain the process of choosing appropriate diagnosis codes.

The ICD-9 book provides a systematic approach to transforming descriptions of diseases, injuries, conditions and symptoms into numeric and alphanumeric codes.  These codes are provided to payers to support the medical necessity of procedures and services provided by our faculty members.  In addition to supporting medical necessity, the codes are used by payers on a broader scale to evaluate utilization patterns and study the appropriateness of health care costs.  It is critical to the entire reporting process that accurate codes are provided.

Topics will likely include: The organization of the ICD-9 book, how to code to the highest level of specificity, what to do if the documentation is incomplete, how "NEC" is different from "NOS", how to handle "rule-outs, probables and possibilities", how to code for visits without a definitive diagnosis, and why the hospital coder coder does things differently.

An ICD-9 manual is required for this session.


E & M Basic Training

This session will specifically focus on the CPT codes used to report the professional services provided by our faculty during face-to-face visits with patients in various settings (Ex. office, hospital, nursing home, clinic).  We will review the specific documentation requirements for these evaluation and management services.

Our faculty members are responsible for choosing the appropriate level of service based on their documentation.  Staff can be very helpful in ensuring that all of the documentation elements are obtained and recorded in a timely and efficient manner.

Topics will likely include: the documentation elements of an E & M service, when to use the 1997 vs. 1995 guidelines, how medical necessity impacts levels of service, determining when a patient is new or established, the difference between a consultation and a referral, what specialists need to know about levels of service, when time matters, and review the categories of codes.

Handouts will be provided for this session.