The Comprehensive Guidebook for Career Success as a Medical Coder
by Donna Avila-Weil, RHIT, and Rhonda Regan, CCS, CCS-P
ISBN 978-1-877810-15-2
Softcover, layflat
448 pages, 7x 9, 2007
Details:
LIVE, CODE AND PROSPER IN YOUR PRIVATE PARADISE
How would you like to have a job that you can perform while living anywhere you choose? Like Hawaii ... or on your favorite mountain with a breathtaking view ... or on the shore of your favorite lake? Here's more - you can be your own boss working from home, and make a good (or great) income while performing a highly-respected profession. Sound too good to be true? Well, it is true and this dream of a profession/life style is being lived today by independent medical coders around the United States and in other countries.
There is an enormous and growing demand for skilled medical coders, creating a severe shortage in a large variety of coding situations. Demand greater than supply sounds like a condition that would result in excellent compensation for those on the supply side. That is also true. So, how do you determine if medical coding is the profession for you? If you are already a medical coder, how do you identify and evaluate the rapidly expanding variety of opportunities open to you?
INDEPENDENT MEDICAL CODING, 2nd edition: The Comprehensive Guidebook for Career Success as a Medical Coder (just published by Rayve Productions) provides answers to these questions and many more, such as What is Coding?; Are You Ready to Go Solo?; What is the Future of Coding in Health Care? The 448-page book also gives extensive information regarding Medical Coding Education and Experience; Continuing Professional Education; Becoming Credentialed; Medical Transcriptionists as Coding Specialists; Salary Projections Based on Survey Data; Types of Coding Systems; Establishing Your Independent Coding Business; Alternative Careers for the Health Care Coding Specialist; Establishing Fees; Marketing Tips; Contracts and Independent Contractors; Building a Successful Coding/Consulting Business; Professional Ethics; Finances; and much more, including descriptions of the authors' favorite references and resources and the appendix's twenty-three exhibits of helpful forms and documents.
Authors Donna Avila-Weil, RHIT, and Rhonda Regan, CCS, CCS-P, have worked extensively in health information management for decades. Avila-Weil has specialized in coding, in medical transcription, directed medical staff services, and provided extensive consulting services during her 30 year career. Regan has performed medical coding for 20 years. She owns her own independent coding and health information management consulting business. Donna lives and conducts her coding, medical transcription, and consulting business in Hawaii, servicing clients across the U.S. Rhonda lives and has her coding and consulting business in the beautiful wine country of Northern California.
Contents:
Introduction
Read It and Weave
What Is Coding?
The History of Coding
Current Code Sources
Annual Coding Updates, Revisions, and Deletions
The Prospective Payment System (PPS)
Diagnosis Related Groups (DRGs)
The Future of DRGs
Accurate Medical Coding ? Purpose and Results in Health
Care Today
How Codes Are Applied
The Purpose and Results of Coding
Coder Shortages
Coding Compliance
Coding Compliance Tools
Coding Guidelines
Are You Ready to Go Solo?
Being Prepared
The Entrepreneurial Personality
Experience and Training
What to Expect
The Rewards of Self-Employment
The Pros and Cons of Independent Contracting
Medical Coding Education and Experience
Coder Education ? Not an Overnight Experience
Coder Boot Camps
Home Study Resources
Job Description ? Coding Specialist
Specific Responsibilities
Other Potential Duties/Responsibilities
Technical Skills Required
Decision-Making and Research Skills
Interpersonal and Organization Skills
Organizations and Websites Offering Education/Training
The Coding Toolbox
Credentials Available
An Independent's Success Story: Michelle Matalone
Continuing Your Professional Education
Knowledge is Power
Workshops and Seminars
Coding Roundtables
Keeping Up with Trends and Technology
Keeping Current on Coding Updates
Becoming Credentialed
Other Sources of Education/Training
What Certification Can Do for You
Guidelines for Using Credentials
AHIMA Advocacy Resolution
Exam Preparation ? Tips for Organizing Materials and
Managing Exam Time
Study Resources
Examination Time
More Tips for CCA Exam Preparation
CCS-P Exam Tips
CCS and CPC Exam Tips
Nurses as Coding Specialists
From Nurse to Successful Coder: Debbie Elliot
Medical Transcriptionists (MTs) as Coding Specialists
Medical Transcriptionists as Coders
A Successful Independent/Coding/Billing/Recovery Specialist: Mary L. Smith
Salary Projections Based on Survey Data
Various Positions in the Coding Field
Networking
Internet Resources ? "Net"-Working
HIPAA ? Health Insurance Portability and Accountability Act
Business Associates
Types of Coding Systems
Interpreting Coding with ICD-9-CM
The Emergence of ICD-10-CM
Coder Transition to ICD-10
Coder Productivity ? ICD-10
Why Switch to ICD-10
Training for ICD-10
HCPCS (Healthcare Current Procedural Coding System)
Level I ? CPT
Level II ? HCPCS/National Codes and Modifiers
What are HCPCS Modifiers?
Introducing APCS
E/M Codes (Evaluation and Management Codes)
E/M Code History
Introduction to DRGs ? Diagnosis Related Groups
Where Did the DRG Originate?
Basic Characteristics of the DRG Classification System
The DRG Assignment Process
The Typical Decision Process Used to Assign a DRG to a Case
Assuring Proper DRG Assignment
How Hospitals Are Paid Via the DRG System
Case Mix
Case Mix Index (CMI)
Medicare Case Mix is Rising
DRG Optimization/Maintaining Compliance
Chargemaster
The Importance of Documentation
Coding Queries
Physician Coder Query Form
Establishing Your Independent Coding Business
New Independent Freedoms
Rewards of Self-Employment
Staying Focused
Consulting ? The Pros and Cons
What Is a Coding Consultant?
Being Ethical
Coding Compliance
Coding Compliance Tools
Fraud and Abuse
Positioning Yourself in the Current Health Care Environment
How to Compete Successfully
Maintaining Your Competitive Edge
M
aking Healthy Choices
Clients and Services
Coding in Managed Care/Physician Practices
Coding for Outpatient/Ambulatory Care Clinics
Types of Services to Offer
Consulting Services to Optimize DRGs
Coding Auditing Services
Medical Record Abstracting for Severity of Illness
Outpatient Coding
Outpatient Surgery Coding
Emergency Room, Laboratory/X-Ray Coding
How Coding and Billing Are Linked in the Outpatient Setting
Benefits/Revenue Recovery
The Recovery Specialist
Fees for the Recovery Specialist
Learning Outpatient Coding and Billing
Computer Setup for Outpatient Coding
Reference Materials for Outpatient Coding
The Work Site ? Home-based Coding
Remote Coding ? An Idea Whose Time Has Come
Offshore Outsourcing
The Electronic Medical Record (EMR)
Medical Facility Benefits of Home-based Coding
The Coder Educator
International Coding Opportunities
United Kingdom
Clinical Coders Society of Australia
Alternative Careers for the Health Care Coding Specialist
Cancer Registry
Functions of a Cancer Registry
Coding Cancer Cases
The Future for Cancer Registrars
Education and Training for Cancer Registry Work
Becoming Certified as a Tumor/Cancer Registrar
A Successful Cancer Registrar ? Valerie McRae
Trauma Registries
History
Basic Training
Achieving Certification
Radiology Coding Certification
Setting Up Business Operations
Planning and Implementing
The Office Environment
Being the Boss Means Flexible Hours
Equipment and Software Needs
Computer Assisted Coding
Encoder Software
How the Encoder "Thinks"
Encoder Pros and Cons
The Alpha II Coding System
What Does Alpha II Do?
Medical Coding Software
Forms
Reference Books and Resource Guides
Building a Web Page
Your Home Page
Marketing and Promoting Your Website
Never Underestimate the Value of Links
Maintaining Your Website
Licensing and Regulations
Professional Liability Insurance
Establishing Fees for Services
Market Research
Rate Variables
Productivity Standards
Marketing You and Your Business
Collecting the Facts
Evaluating Your Background and Experience
Evaluating Your Market and Competition
What Is Needed
Fliers
Clients
The Power Resume
The Power Letter
Follow Up with Potential Clients
Keep Track of Your Contacts
Your Client Relationships
The Interview
What to Bring with You to the Interview
The Winning Image
What Not to Do
Closing the Interview
"Net"-Working
Professional Image and Attitude ? Inspiring Confidence
Coding Contracts
Verbal Contracts
Contract Decisions ? The Details
Contract Decisions ? Other Information
The Director's Concerns
Contract Management in Health Care
Maintaining the Contract
Commitments
The Business Associate Agreement
Business Associates
Building a Successful Coding/Consulting Business
Establishing Priorities
Facility Requirements
Developing Good Working Relationships
Getting and Retaining Clients
Selecting Clients
Moonlighting ? Don't Quit Your Day Job Just Yet!
Professional Ethics and Compliance
Coding Principles
Where to Find Answers to Coding Questions
Unethical Coding
Ethics for Outpatient Coders
Ethics in the DRG System
he CPT System
Other Coding Concerns
Optimization Through Quality Coding
Coding with Appropriate Documentation
How to Apply Codes
When Not to Code
Documentation Concerns
Compliance and Quality Improvement
Maintaining Confidentiality
Confidentiality and Home-based Coding
Doing Business Under HIPAA
The Privacy Rule
The Business Associate
The Business Associate Agreement (BAA)
Important Coding Security and Privacy Issues
Faxing Health Care Documents
Online Information Security
HIPAA Compliance Policies and Procedures
HIPAA Compliance Training
The Security Rule
Disaster Recovery
Keeping Records
Coding ? Daily Log Sheets/Audit Control of Work Flow
Resources for This Section
The Independent Contractor
Benefits to Independent Contractors
Risks to Independent Contractors
Independent Contracting and the Twenty Common Law
Principles
The Six Factor "Economic Realities" Test
The Reality Check
Subcontracting
Assistance from the Chamber of Commerce
Having the Appropriate Documents in Order
Additional Reference Materials
Finances
Financial Needs and Capital Investment
Watching Your Costs and Expenses
Using a Business Credit Card
Equipment ? Leasing or Renting Versus Buying
Leasing Equipment
When Not to Lease Equipment
Paying Yourself
Tax Incentives: Business Taxes
Types of Taxes
Federal Taxes
Form 1099 and Your Business Income Taxes
Tax Deposits
Social Security Taxes (FICA)
Checking Your Social Security Record
Employer's Identification Number (EIN)
Estimated Tax Payments ? A Horror Story!
State Taxes
Home-Sweet-Tax Deduction
When the Home Office Deduction Is Not the Best Option
Automobile Expenses
Interest on Car Loans
Who Should Lease and Who Should Buy a Car?
Business-related Travel Expenses
Education Expenses
Expensing and Depreciation
Records Needed for Tax Purposes
Tax Sheltering Through Retirement Plans
Simplified Employee Pension (SEP)
Individual Retirement Account (IRA)
Health Insurance
Should You Hire an Accountant, Bookkeeper or Tax Preparer?
The Future of Coding in Health Care
Favorite References and Resources
Associations
Websites
Bibliography
Journals and Publications
Glossary
Appendix: Contains 23 Exhibits
Index
Exhibit I ? AHIMA Code of Ethics 2004
Exhibit II ? AHIMA Standards of Ethical Conduct
Exhibit III ? AHIMA Statement on Health Information Confidentiality
Exhibit IV ? AHIMA: Confidential Health Information and the Internet
Exhibit V ? HIPAA Security Guidance
Exhibit VI ? Business Cards
Exhibit VII ? Record Completion Log
Exhibit VIII ? DRG Optimization Worksheet
Exhibit IX ? DRG Contracting Worksheet for Chart Review
Exhibit X ? DRG Optimization Summary Worksheet
Exhibit XI ? Personal Time Sheet
Exhibit XII ? Billing/Invoice Form
Exhibit XIII ? Invoice Form for DRG Contracting
Exhibit XIV ? Sample Business Associate Agreement
Exhibit XV ? Sample Coding Contract
Exhibit XVI ? Schedule A ? Fee Schedule
Exhibit XVII ? Schedule B ? Nondisclosure Agreement
Exhibits XVIII through XX! ? Coding Summaries
