Sicker patients do not always mean higher MDM.

If your physician bills a lot of high-level office visits, he may be in danger of an audit, which may not be a cause of concern if his documentation justifies his code choices.

"Some doctors think that their patients are sicker than others'; as such they feel they are justified using more 99215s, when in fact that may not be the case," according to Crystal S. Reeves, CPC, CPC-H, consultant with Coker Group in Alpharetta, Ga. "The CPT manual outlines the requirements of the evaluation / management codes , there're clinical examples in the back of CPT, and CMS publishes a table of Risk that can guide you, so use all of those resources to find out wherever you are billing properly, "she says.

Training is important: If you advise your doctor that he's overbilling the high-level codes and he says, "But all of our patients are in actuality sick," show the doctor CMS's Table of Risk, "which can be an eye opener for doctor , "says Reeves.

According to Reeves, when it comes to MDM for high-level evaluation / management services, "look for how many diagnoses or management options the physician is treating." If a patient presents with a brain tumor and is chemotherapy but is faring well, his condition may always be terminal however this visit may not qualify for a level five. However if the patient has COPD, hypertension, degenerative disc disease, pneumonia, and diabetes, there'll be more data to review, which may qualify for a higher MDM level. "

You should make diagnosis coding a priority: If your claim does not convey the status or complexity of the condition, an auditor will not be able to infer it, Stephanie L. Fiedler, CPC, ACS-EM, director of revenue management with YAI in New York, NY says. "The best option to do this is to report your diagnosis codes to the highest level of specificity."

If a diagnosis code is not listed on your superbill, do a research to find it rather than just using one that you do to list on your encounter form.

"Certain diagnoses may not be listed on a physician's superbill; as such the physician may just circle the closest unspecified code," says Fiedler. For example, a physician might circle the standard controlled diabetes code on a superbill as it is there, "however any time there are renal, peripheral vascular, or ophthalmic complications, those are the ones that have to go back to the coding book for and most of the time, they do not, "she says.

"Minus the more specific code, the doctor is not conveying the acuity of what he is doing, so the diagnosis may not support the claim."

There are different ways of acquiring the skills essential for medical billing and coding. One of them is going for an appropriate medical billing and coding course. There are many schools doing the same job to teach the relevant skills of medical field. Moreover you can learn it over internet but obtaining a good course is really essential. Above all, having a valid course increases the chances for better career for the trainees. Medical billing and coding is a very important part of the medical sector and to be a successful professional in this field you need to be equipped with sufficient skills and practical knowledge. This is only possible if you opt for a course offering such advantages.

Many schools offer online courses to the students seeking to obtain certification in billing and coding. The duration of such course is generally 6 months and it teaches the students not only basics but also imparts practical knowledge side by side. Thus, choosing the right course is very important. These courses can be for obtaining certification or for receiving an associate degree. Hospitals and insurance firms prefer the professionals who possess associate degree since they are much trained as compared to the coders and billers. Moreover, it is vital to consider the accreditation of such course i.e. whether they are accredited or not.

Secondly you should look for whether such course is meant for medical billing, medical coding or both. Nowadays schools offer courses which deal with both medical billing and medical coding. Opting the course also involves consideration of risk factors i.e., whether they are worth the fees paid or not. Sometimes the area you live in does not possess the requisite opportunities in medical services. In such cases you should carefully consider the factors before going for any such course.

In the web development industry, the demand of PSD to WordPress conversion is incredibly gaining momentum. The reason is simple – this CMS comes with advanced multi-functionalities. As per market reports, it has been outlined that blog publishing app WordPress is often used by majority of web developers to manage their website content through custom post type. What does custom post type stands for? It is an amazing technique seamlessly used by WordPress programmers to create post types according to their needs.

First Glance at some useful WordPress coding snippets for custom post type through high-quality PSD to WordPress conversion:

• Individual Style Post: Style blog post individually by using ” post_class() function ” and the post ID. Simply open single PHP based file and replace the loop.
• Use thumbnails to display recent post: Say yes to thumbnails for displaying a list of all the related blog posts below latest post to offer online readers something extra.
• Multiple Sidebars: Sidebars are mostly used to display large amount of information such as related posts, author info, a blog roll etc. Unfortunately, different sidebars become very busy and readers unable to find what they are looking for. To make multiple sidebars available simply duplicate sidebar php file then include information to be post and save file as sidebar > content > php.
• Drop-Down Menu For Tag Navigation: It is always good have tags to categorize content but displaying cloud tags is the biggest challenge. Therefore, it is advisable to create drop-down menu of easy navigation of the tags on particular web-page.

However, converting PSD to WordPress template for custom post style by using the above mentioned WordPress coding techniques is not so tricky for people with solid understanding of HTML/XHTML/CSS mark-ups. On the other hand, if you are unaccustomed with HTML/XHTML codes then it is advisable to hire WordPress developer otherwise digging around code can really become nightmare for you. Ease down the entire process of PSD to WordPress conversion bit by considering the above discussed WordPress coding snippets.

Physicians are very often so stressed out with seeing an increasing number of patients, providing medical services and appropriate follow-ups that they hardly get any time to see to the coding and billing processes themselves. Practices may have in-house staff whose hands may be full with other tasks. Documenting the medical records, carrying out the coding and billing opportunely, and submitting the claims to insurers are however, all very important from the point of view of the revenue inflow to the practice. Either physicians themselves have to oversee the coding and billing patterns of their practice, or get a medical billing company to do the same before the actual claim submission. Medical bills containing missing or incorrect information usually do not get paid, thus having a negative impact on the practice’s financial condition. Other coding errors include undercoding and overcoding – the former when the codes assigned do not capture the complexity of the service provided; and the latter when the codes report a more complex procedure than what was actually provided. Both undercoding and overcoding can prevent proper reimbursement and even trigger an audit from the payer. This can be avoided if the medical practice avails of the services of a medical billing company to carry out a medical coding audit to identify any pitfalls in the in-house medical coding process.

Medical Coding Audit – What It Involves

Medical coding audit involves the review of a provider by an external agency such as a medical billing company that has expertise in the provider’s specialty. Such a review will be unbiased and provide a clear idea regarding the practice’s coding standards, accuracy and compliance with all applicable rules and regulations. The audit will bring to light errors and misunderstandings if any, regarding coding and ensure that the physician practice incorporates all the latest coding updates and rules.

A large majority of the claim denials and lower reimbursement result from inaccurate coding and common misconceptions coders have. These can be easily identified at the time of the audit. Coding audits by an efficient medical billing and coding company can also help identify errors or missing information in the medical records on the basis of which the coding is done. This means that the physicians will get a cue to improve the quality of their medical records, thereby giving clearer information to the coder so that only the correct codes are used. Moreover, clarity in medical records is also important with regard to providing better quality patient care.

Be Prepared for RAC Audits

A practice that has a regular medical coding auditing system in place is well prepared for any RAC audit. RACs are recovery audit contractors that are employed by the CMS (Centers for Medicare and Medicaid Services) to identify overpayments and reimburse those to Medicare. They also identify underpayments if any. The RACs receive a percentage of what they recover in overpayments and are therefore rather ruthless in their audits. Hospitals, physicians, home health agencies and durable medical equipment providers are all subject to RAC audits. According to the RAC, overpayments and underpayments are considered improper payments. These include payments for services that are not covered such as those that are not medically necessary, services that are incorrectly coded, and duplicate services.

With a medical billing and coding company providing medical coding audits for you, you will already be aware of any errors or inconsistencies prevalent in your practice and correct them well ahead of an impending RAC audit. You stand to benefit in terms of time, money and reputation. The best thing about having an audit done regularly is that you can also identify underpayments if any, and proceed to claim the due reimbursement. Regular reports given by your partnering medical billing company will help you improve your practice’s performance.

Using Microsoft SharePoint 2010 chart web part, you can quickly create charts with data from SharePoint Lists and other data sources. Here's how.

Microsoft SharePoint 2010 comes with a built in Chart Web Part, which lets you build interactive charts quickly, and without writing a single line of code, using data from various sources, such as SharePoint lists, Microsoft Excel spreadsheets, SQL Server databases, and so on. This offers a major advantage, letting you add interactive charts to presentations in a jiffy. Here's how you can go about creating a chart with this handy tool.

1. Create a Microsoft SharePoint custom list and give it a name. Include 3 custom columns, all of which should be of type – Single Line of Text.
2. Once the list is ready, add some data to it.
3. Create a new page in SharePoint by clicking on Site Actions, and then New Page. Give it a name.
4. Click on the blank area in the middle of the page and select the Group named Editing Tools. From the ribbon, select Web Part. On the categories pane, select List and Libraries. Now click on the name of the custom list you created in step 1, and click on the Add button.
5. Repeat step 4 and select Chart Web Part under Business Data category.
6. Now click on Data and Appearance on the Chart Web Part. In the wizard that opens, click on Connect Chart to Data.
7. Select Connect to a List. Click on Next.
8. Select the list you created earlier. Click on Next.
9. Once again, click on Next.
10. From the drop down for Y-field, select the appropriate name from your custom list.
11. Click on Finish to create your chart.
12. Now click on Data & Appearance.
13. Click on Customize Your Chart to add graphical enhancements to your new chart.
14. Tinker around with the options given in the section named Select Chart Type. Once you are satisfied, click on Finish and your chart will be ready.

Creating a chart with the Chart Web Part of Microsoft SharePoint 2010 can help you visualize data stored in SharePoint lists, external databases, or even Microsoft Excel spreadsheets, depending on the software being used to manage data in your organization. However, if you use third party add-ons, you might be able to incorporate additional visual elements to your charts. That way, you will have access to additional chart types, color schemes, and even the option to export the visualizations in different formats, or print them directly through the add-ons themselves.

What is medical classification and what is medical coding? Well, both the terms refer to the process of transforming details of medical diagnostic processes and diagnosis into medical code numbers that are universal. The four basic categories of coding are diagnostic codes, procedural codes, pharmaceutical codes, and topographical codes. The diagnostic codes are used to group and identify diseases, disorders, symptoms, and medical signs, and the procedure codes are numbers or alphanumeric codes used to identify specific health interventions that are taken by medical professionals. While the pharmaceutical codes are about medications the topographical codes indicate the concerned body part.

From where are all these details about the patient’s disease and his medical history taken? Some of the sources include,

• Doctor’s notes
• Biochemistry Lab reports
• Radiology reports

What is the use of these medical codes? They are used to track diseases and quite useful for health insurance companies, government hospitals, worker’s compensation carriers etc. These medical coding/ classification system applications are mainly used for reimbursements of the medical bills from insurance companies. It is also used for statistical analysis, in epidemic surveillance and for knowledge based decision support.

Here are the different types of medical classifications;

• Reference Classifications
• International Statistical Classification of Diseases and Related Health
• International Classification of Functioning, Disability, and Health
• International Classification of Health Interventions
• International Classification of Primary Care
• International Classification of External Causes of Injury
• Anatomical Therapeutic Chemical Classification System
• Technical aids for persons with disabilities: Classification and terminology
• International Classification of Diseases for Oncology, Third Edition
• ICD-10 for Mental and Behavioral Disorder
• Application of the International Classification of Diseases to Dentistry and Stomatology
• Application of the International Classification of Diseases to Neurology
• International Classification of Functioning, Disability and Health for Children and Youth
• Procedure Coding System
• Diagnostic and Statistical Manual of Mental Disorders
• Systematized Nomenclature of Medicine
• TNM Classification of Malignant Tumours
• Unified Medical Language System
• Mendelian inheritance in Man
• Current Procedural Terminology
• Health Care Procedure Coding System
• North American Nursing Diagnosis Associates
• Logical Observation Identifiers Names and Codes
• International Classification of Headache Disorders 2nd Edition

How important is the way a glucose meter takes readings? In a recent press release, American Diabetes Services (ADS) endorsed Ascensia test strips, saying they significantly reduced inaccuracies in glucose readings. The other meters they tested weren’t necessarily inaccurate when used correctly, but both One Touch and Freestyle glucose meters required test strip coding, while Ascensia’s test strips require no coding. Why should this make enough of a difference to cause the ADS to take notice?

What Is Coding?

Most glucose meters use a plastic test strip dosed with glucose oxidase. These strips can vary from batch to batch, and most test strips will have a code or a chip for the user to enter before using the meter with the new batch of strips. Entering the code calibrates the glucose meter and the diabetic test strips so that the reading will be accurate, based on the amount of glucose oxidase on the strips in the package.

However, if the user forgets to recode the meter when he or she begins to use a new box of test strips, or if the user enters the code improperly, the readings will be incorrect. The inaccuracies vary, but the readings can be off by as much as 43%. For people actively managing diabetes, an incorrect meter can mean taking the wrong dose of insulin, which significantly increases that person’s risk of hypoglycaemia and other diabetes-related complications.

Why Don’t Ascensia Test Strips Have to be Coded?

Unlike most glucose meters, Ascensia Contour test strips and meters are self-calibrating. Ascensia’s “no coding” claim isn’t that no coding is involved, but that it doesn’t have to be done manually. While most test strips require the user to enter a code, insert a coding strip, or insert a chip into the glucose meter, Ascensia meters automatically calibrate by checking the strip electronically when it is inserted into the meter, and the Bayer company, which makes the Ascensia Contour and Ascensia Breeze meter, claims that it cannot be miscoded using this system.

Should I Switch?

The study did not find significant accuracy discrepancy between Ascensia meters and other brands of meters when the devices were coded correctly. The reason for ADS’s endorsement has almost everything to do with the frequency of human error. If the meter is coded improperly, the results could be potentially dangerous; if the user is careful to double check when switching boxes, he or she shouldn’t have any significant problems testing glucose levels. The question comes down to self-evaluation. Users must ask themselves whether they are prone to carelessness or impatience when they are performing a task that has to be repeated day after day. Meters without coding simply take out one more place where human error can occur.

Ascensia products are not significantly more expensive than other meters, and are actually less expensive than some. While some diabetics may not have a choice because of Medicare requirements, if they choose to avoid the hassle of coding a meter from another company, the price should not be much of a deterrent.

There are a great many different careers that can be pursued after completing billing & coding school, with a great opportunity for advancement within the field as well. You have a great opportunity to enter a constantly growing and expanding career with an excellent earning potential. Billing and coding professionals are in high demand within the health care sector as they are needed in every sector to perform a variety of functions. Entering these careers is a long-term decision that will provide you with a lifetime of financial security and an open path for success.

How to Enter the Field

If you have thought about the many benefits and functions of the many billing & coding careers, and have decided that this is the profession for you, you must begin with medical billing and coding school in order to get the appropriate education for the career you plan to enter. You can take a specialty program that focuses on a certain area of the field such as a specific health care market, entity, or level of the position you are seeking. For instance, you can take management and supervisory classes in order to enter the profession of your choice on a higher tier within the organization.

Possible Careers

There really is a great selection of billing & coding careers you can enter through the appropriate classes. Such jobs that are possible with a billing and coding degree include:

• Medical billing specialist
• Clerk
• Medical coding specialist
• Medical assistant
• Medical billing consultant

Once you have earned your way through the profession and have a bit of management experience and education under your belt, you can certainly use your medical billing & coding knowledge to start your own billing company, servicing health care facilities in a broad area or even nationwide.

Functions Included in Careers

There are many tasks of the various billing and coding careers. You will work a lot with various elements within the clerical section of health care facilities including:

• Health insurance claims
• Medical documentation
• Billing management
• Government benefit programs
• Electronic data

No matter what level of the field you enter, you will be performing some level of work with these elements. The tasks include performing the data collection to coding, communicating with patients, communicating through the Human Resource department, and even managing the completion of the tasks involved.
Entering the medical billing and coding field is a great step in creating a career path that will lead directly to lifetime success. You want to enter a career that is going to provide advancement, great earning potential through time, and is in high demand to ensure you will always find employment no matter where you go.

Billing & coding careers offer these things and much more, including the opportunity to expand your medical knowledge and join an industry that is highly needed and well appreciated within communities around the world. You have no limits within the industry and billing and coding is a great way to start.

Without professionals who operate using high standards and who have received medical billing and coding certification, a suspicious charge on your bill may end up damaging your credit score. Health finance professionals believe that up to 40% of hospital bills will contain billing errors. A Boston-based health care advocacy group, the Access Project, believes that number is closer to 80%.

Medical billing errors can reduce your credit score. Results from a study from the Federal Reserve indicate that medical bills account for more than half of all the debt currently in collection. Inaccurate billing by a physician office and hospital can increase your financial debt and can be more than just an inconvenience.

Hospitals and physician offices are looking for professionals who have received certification in order to demonstrate their knowledge and reduce the potential that they will produce in billing errors. These billing errors impact, not only the patients and their credit score, but also the trust that patients have in their hospitals and physicians.

Interestingly, some healthcare experts believe that the number of errors may jump in the coming years because of the electronic health records included in the $19 billion stimulus package. The US Department of Health and Human Services hopes that by 2014 at least 80% of hospitals will be using electronic records. Although the intent is to reduce the number of errors, logistically these errors may increase exponentially.

This is because electronic record-keeping in the hospital begins on the hospital floor with nurses and certified nursing assistants entering information into the computer records that generates codes for reimbursement. Any time dressings, fluids, antibiotics or medications are administered, the information is entered into a medical record but also generates a code for insurance reimbursement. If the certified nursing assistant, nurse or physician enters the wrong item and patient can be overcharged or under charged.

The good news is that these billing errors can be corrected when patients are willing to look through their hospital billing records to ensure that they received everything that was charged. Unfortunately, if you do find an error, it can take serious legwork and long hours on the phone in order to resolve the issue. However, without resolution, these billing errors can significantly impact your credit rating.

Hospitals and physician offices to use electronic medical billing services will find that employment of individuals who have received certification can help to reduce their overall errors. Conscientious professionals must spend hours pouring over bills and medical records to ensure that the correct coding is sent to insurance companies and third-party payers.

If you are feeling stressed because the medical coding certification exam is arriving closer and closer, you need to be aware of a few tips to help you prepare for the exam as well as study for it. Whether you are taking the exam by the AAPC or AHIMA, there are several steps you want to be aware of to better prepare yourself before it is too late. You may want to take a preparation course, collect practice exams, or use a study guide to help you review on certain topics you may not have a complete understanding of at the moment.

Experience matters

Since part of the job responsibilities of a medical billing and coding specialist requires that you process patient treatment records, you need to make sure you have the medical terminology knowledge as well as anatomy knowledge before you begin to prepare for this certification exam. You may want to intern at a physician’s office while you are in school so you can have a better understanding of everything a medical billing and coding specialist does on an everyday basis. On the day of your exam, you want to have some knowledge as well as experience so you will not be concerned about the toughness of the questions.

Practice exams

By collecting several different practice exams, you will have a better understanding of the amount of difficulty the questions will be on the real CPC exam. You could either ask your school instructors for a practice exam or you can find a few different ones online that you can print out. By taking them online instead of printing them out, you will find out your score as soon as you take it and you will also see the problems you missed as well as why you missed them. It is better to collect as many as you can at least six months before you end up taking your actual exam so you can take your time and are able to go into a lot more detail about each question in case your CPC exam will ask you more questions about each one of the questions you answered on all of your practice exams.

Study guides

Having a study guide will definitely help you prepare for the exam because it will help you study in a more organized fashion and will also prepare you for the exam by giving you a few sample questions within each topic. Your study guide may also give you an outline of each topic so you can refresh your memory in case you have forgotten, and it will also help you with the more difficult topics that you are not able to understand.

Keep calm and prepare thoroughly

By taking in all of these strategies to prepare for your CPC exam, you need to use those to help you study as well. If you are the kind of person that has really high-test anxiety, then you want to take each topic and review a little bit each day. It helps if you could create a blank calendar and assign times as well as days of the week for each topic so you are not cramming everything in on the same day.

The more you prepare for the CPC exam given by the AAPC or AHIMA, the more confident you will feel as the exam day approaches. By developing study techniques that work for you, you will also feel less nervous and more relaxed as well as having the confidence in yourself that you can ace the exam and receive a great and high-paying job.