So Many Books, So Little Time - Part 3

Yes, it's true.  There are so many books and so little time, I haven't even had time to blog for the last two weeks because I had my nose in two of them.  Thank God for smartphones and long waits at the car wash, or who knows how much longer it would been before I posted again!

In my first post of this series, I gave one of my favorite quotes: "ICD is from Mars, HCPCS is from Venus."  So let's move on to Venus for a bit.  Don't worry, we'll be back to Mars, but I like to talk about the present before I talk about the future (ICD-10), so let's get on with it.  I apologize for the length of this post, but I have a lot to say today!

Three Levels of HCPCS
The Healthcare Common Procedure Coding System (HCPCS) has three different levels and just to make things more interesting, Level I is not usually called HCPCS, it's called CPT.  The Current Procedural Terminology (CPT) was developed and is maintained by the American Medical Association (AMA).

By Physicians for Physicians
What makes CPT so unique is that it is the only coding system in the HIPAA-approved code sets that is developed by physicians for physicians.  The codes you see in the CPT code book are the result of various medical and surgical societies coming together with the AMA to decide which procedures deserve their very own CPT codes.  Every year at the AMA's CPT Symposium, coders from around the country gather in Chicago to listen to these physicians present the coding updates for the coming year.  It's an expensive but valuable conference that I think every coder should experience at least once.  

CPT codes are primarily used by physicians to report procedures and services performed in every possible setting where a physician - or qualified health practitioner - may see  a patient: his office, the hospital, a clinic, a nursing home, etc. But it doesn't stop there.  CPT is also used to report hospital outpatient procedures. Of course, since there are still a lot of procedures that are performed solely as inpatient, hospital coders use a small number of CPT codes in comparison to pro-fee (physician) coders. 

Three within Three

So now that we know that CPT is one of three levels of HCPCS, let's delve a little deeper into this major code set. CPT has three categories of codes and this is still a pretty new concept for me because when I was learning, there were no categories, just CPT codes. 

Category I Codes

Category I codes are the original CPT codes they're what I like to call "grown-up" CPT codes. In order to get a grown-up CPT code, a procedure has to meet some pretty stringent criteria: 

• The procedure must have FDA approval
• The procedure must be commonly performed by practitioners nationwide
• The procedure must have proven efficacy

Once these criteria are met, a five-digit numeric code is assigned to the procedure and unlike ICD (different planet, remember?), these codes do not have decimal points. The codes are arranged in sections by type of procedure or service:

• Evaluation and Management (E/M) (codes beginning with 9)
• Anesthesia (codes beginning with 0)
• Surgery (codes beginning with 1-6)
• Radiology (codes beginning with 7)
• Pathology and Laboratory
• Medicine (the rest of the codes beginning with 9)

The Surgery codes are divided by specialty, for example, the cardiovascular codes begin with 3 and neuro codes begin with 6. After coding for a while, you should be able to look at a CPT code and have a general idea of what it is. A common newbie mistake is to look for the E/M codes in the back of the book. After all, they begin with 9!  But remember that CPT is a coding system that was developed by physicians for physicians and since physicians use E/M codes more than any others, they are in the front of the book for quick reference. 

Here are a few examples of Category I CPT codes:

• 99283, Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity
• 12002, Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.6cm to 7.5cm
• 75625, Aortography, abdominal, by serialography, radiological supervision and interpretation 

Category II CPT Codes

Category II CPT codes are located behind the Category I CPT codes in the book. These are the only CPT codes that are optional. They are used by physicians for tracking performance measures. The purpose of these codes is to decrease administrative burden on providers while collecting information on the quality of patient care. Category II codes are five-digit alphanumeric codes that end in "F."  Here are some examples:

• 1040F, DSM-5 criteria for major depressive disorder documented at the initial evaluation (MDD, MDD ADOL)1
• 3775F, Adenoma(s) or other neoplasm detected during screening colonoscopy (SCADR)12

Category II CPT codes are implemented throughout the year and may be implemented before they actually appear in the CPT book.  Code updates can be accessed on the AMA's website. 

Category III CPT Codes

Category III CPT codes, or "baby codes," as I like to call them, are for emerging technologies that do not meet the criteria of a grown-up Category I CPT code. The Category III codes are found behind the Category II codes in the CPT book. For procedures that are not commonly performed, lack FDA-approval, or don't yet have proven efficacy, Category III codes are assigned. These are temporary codes for a period of 5 years. It has become common practice to see Category III codes reach Category I status with each annual update. For 2015, one of those procedures that was moved was transcatheter mitral valve repair with a prosthesis. The MitraClip uses this relatively new technology to treat mitral regurgitation and it received FDA approval in 2013. 

These are five-digit alphanumeric codes that end in "T." The codes are added throughout the year and may be implemented before they are published in the CPT book. Here are some examples of some Category III codes:

• 0387T, Transcatheter insertion or replacement of permanent lead less pacemaker, ventricular
• 0274T, Percutaneous laminotomy/laminectomy (intralaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy) any method under indirect image guidance (eg, fluoroscopic, CT), with or without the use of an endoscope, single or multiple levels, unilateral or bilateral; cervical or thoracic

Updates to Category III codes can also be found on the AMA's website throughout the year.  

Staying Updated

Back in the day, it was important just to make sure that you had the most recent year's CPT book to ensure you were using valid codes. However, with the Internet, now it's also important to monitor the CPT updates and errata on a regular basis since changes are made throughout the calendar year. I find it easiest to put a reminder on my calendar the first of each month to check the AMA's website for updates to the errata, which is a list of corrected errors in the CPT code book, as well as changes in Category III codes. Since I don't use Category II codes, I forego that update, but if you are coding them, be sure to look for those updates too. 

By the way, the errata is on the list of approved materials for the AAPC exams. The year I took the CIRCC exam (Certified Interventional Radiology and Cardiology Coder), there were a lot of errors in the electrophysiology code notes and the errata was something I really needed.  Be sure to check it out!

Modifiers

HCPCS codes have a concept specific to HCPCS codes only: modifiers. Think of modifiers like moons that are specific to a planet (and please forget for a moment that Venus doesn't have any moons!). Modifiers apply to HCPCS codes only, not ICD-9-CM codes. They are added to HCPCS codes to provide additional information, such as a bilateral procedure or an unusual service or to indicate that a procedure was discontinued. CPT modifiers are two numeric digits that are appended to a HCPCS code with a dash (e.g., 75710-59). 

All CPT Coders are not Created Equal

The people who assign CPT codes are just as complex as the coding system. Since hospital coders code only a subset of CPT codes, they don't have the same skill set that a pro-fee coder has. Remember that hospital inpatient coders use volume 3 of ICD-9-CM to code procedures. Hospital outpatient coders assign CPT codes for procedures that are found in the outpatient setting. So while the pro-fee coder coding for the cardiologist will code everything from a clinic visit in the physician's office to an angioplasty in the hospital cardiac cath lab to a full blown coronary bypass in the hospital's OR (all using CPT, of course), the outpatient hospital coder would only use CPT to code the angioplasty. Hospitals don't follow conventional E/M rules and coronary bypass is an inpatient procedure that gets coded using ICD-9.   In addition, many of the modifiers used by hospitals are different than those used by physicians. 

These differences are one of the reasons it's so difficult to make the crossover from hospital to pro-fee coding and vice versa. I personally hate E/M coding but I know people who love it. So if you find that one area of coding is not really your cup of tea, fear not!  You may find another area very rewarding. 

I also really can't talk about CPT without bringing up a little tiny thing from the hospital side called a charge description master (CDM), or as it's more commonly called, the charge master.  It's as masterful as it sounds: a line-item listing of everything a hospital department charges for.  Each line item has a description of the charge, charge amount, and sometimes a CPT code.  One of the most difficult transitions I see in pro-fee coders crossing over to the hospital side is not understanding that the coder doesn't code everything.  There are many codes that are assigned automatically by the charge master when a charge is applied to the bill.  This is the case when the CPT code doesn't require a lot of subjective reasoning (e.g.,  lab test or x-ray).  For those procedures and services, such as operative procedures, that require subjective reasoning, a real-live coder will assign the code.  It may sound counter intuitive, but this actually increases the amount of coding-related jobs in a hospital.  The charge master analyst requires coding knowledge as he/she works with hospital departments to set up charges, research appropriate CPT codes for the procedure or service, and determine if it will be hard coded (by the charge master) or soft coded (by a person in coding).  

CPT Made (Too?) Simple
This posting really oversimplifies the CPT code set (that's right, it gets more complex!), but it's a start if you're still finding your way in the coding field.  I have a love-hate relationship with CPT because I find it both challenging (love!) but also frustrating when I hear conflicting coding advice between CMS, the AMA, and medical/surgical societies (hate!).  If you find that you love all aspects of CPT, then you can have a very lucrative career in either the pro-fee or facility coding arenas.

Stay tuned to this series...  Next up is HCPCS Level II.

Evolution of the Coder

When I started the HIM program at the local community college in... ahem, a few years ago (sly smile), I split my time working as a file clerk in a doctor's office and a catch-all clerk in a physician's billing office. The doctor's office was a family practice managed by the owner of the billing office, which was located just next door. I remember my coworkers asking me why I was going to school to learn about medical records because I was already a file clerk. I also remember hearing one of the billers grumble about an insurance company denying claims for a male patient with pelvic pain and "can't men have pelvic pain?!"

Well, it didn't take me long to realize that the HIM field was more than filing - especially these days as hospitals and physicians move to electronic health records. And it didn't take me long to learn that, at least in the eyes of ICD-9-CM, men can't have pelvic pain - at least not the kind classified to code 625.9, Unspecified symptom associated with female genital organs (as evidenced by the word "female" in the code description and the little female symbol next to the code).

That was a long time ago and a lot has changed in the coding (and HIM) field since then. As a consultant, I work with hospitals to identify areas for coding education and then develop a curriculum and deliver training. It used to be as simple as telling my client to have all their coders at the training at a specific time and date. But not anymore. You see, the coders in a hospital aren't just sitting in the coding unit (physical or virtual) anymore. There could be coders all across a hospital. There could be people coding who don't even know they're coding. There could be nurses working with doctors to improve their documentation to ensure proper code-based reimbursement. There could be clinic coders coding the professional side for physicians working in hospital-based clinics. Finding coders in a facility is a challenge!

In short, coding has evolved.

And this is a great thing - this means that if you have the skill to be a coder - and it is a skill - there are many directions your career path can take you. So what's your passion? Do you relate to transactional work? Are you production oriented? Do you like the clinical puzzle involved in coding and secretly harbor fantasies of being Dr. Gregory House and solving the diagnostic dilemma in front of you? Do you like finance? Are you a data hound? Do you love to do research? If you answered yes to any of the above, there's a niche for you in coding.

The Transactional/Production Coder
I'll be honest. As a coder, my production, in general, stinks. At least it did the last time I did it. Some days I could concentrate very well and knock out a bunch of records. Some days it was like ADD kicked in and I just couldn't concentrate on the documentation in front of me. But there is a group of very special people who are production-based and enjoy transactional work. These are the people who are a coding manager's dream. They come to work, know how many accounts they need to code for the day, and they get it done. I have a lot of respect for those people. I wish that was me!

The Dr. House Coder
I use the TV show, House, a lot in my training sessions and blogs. I watch it and see if I can diagnose the patient before Dr. House. Usually not. But it's fun to try! Physicians and nurses alike are often surprised when they talk to coders to learn how much coders know about clinical practice and disease process. If you read enough medical records in your lifetime and see the treatment plans, it starts to rub off! If you love the clinical stuff like me, there's a lot of opportunity. Clinical documentation improvement (CDI) programs are popping up all over hospitals. The point: get the physician to document as specific as possible to ensure proper reimbursement for the hospital. Clinical documentation specialist (CDSs) are on the floor, looking at charts while the patient is in-house and talking directly with physicians. This is a job that can be done by a nurse or a coder who has been given proper clinical training. Some hospitals employ both coders and nurses as CDSs for a collaborative effort. I don't really have a desire to go back to working for a hospital, but if I did, I think I would like to be a CDS.

The Code-Based Reimbursement Coder
More and more I see coders being placed in the billing departments of hospitals. Or certified coders being given the role of charge description master (CDM) analyst. As Medicare and other code-based payers get really sticky with their billing requirements, it gets more difficult to get a clean claim out the door. Coders working on the revenue side are typically ensuring hospital systems that incorporate the use of codes are updated and interfacing/functioning properly.

A CDM analyst maintains the hospitals list of charges. If you're looking for a picture of what a CDM looks like, it's a massive spreadsheet for each department in the hospital with a line item for everything they could possibly charge for along with prices for those services and supplies. And some of those line items are attached to codes. CDM analysts work with clinical department heads to make sure charges are set up for all their services and supplies. They also make sure CPT and HCPCS codes in the CDM are updated according to regulatory standards. They might be called into a clinical department to assist in training personnel who are responsible for charging.

For lack of a better title, the code-based reimbursement analyst (an aptly named title I borrowed from a former employer where I was responsible for training code-based reimbursement analysts), is a catch-all before a claim goes out the door. Or someone who audits claims and makes corrections. This person may be responsible for working NCCI edits to get claims through the hospital scrubber and may also work closely with the coders, educating them on the latest Medicare reimbursement changes.

Code-based reimbursement analysts may also be placed in departments prone to frequent coding and charging errors, like interventional radiology, wound care, or injections and infusions. These specialty coders often work not only with documentation, but also with nurses entering charges and physicians regarding their documentation. They may also have a link to billing so they can see how their coding is translating to claim denials and errors.

If you like the revenue and compliance side of coding, there are lots of opportunities for you. Students and recent grads interested in this area often ask me where they can get training or certification for this type of job. Well, there really isn't a specific type of training for it. The best thing you can do is try to get your foot in the door and learn on the job. The coding piece of this is probably the hardest - the rest you learn from your employer. Revenue cycle is part of what I do as a consultant and I like it. I particularly like trying to figure out the complex changes Medicare has put into effect and walking that tightrope between ensuring the provider is getting paid as much as possible while maintaining revenue compliance. Let's just call this code-based coder the "Goldilocks" coder - don't code too much, don't code too little, code just right!

The Data Coder
Maybe you like analyzing data. I for one, find it dull after about 15 minutes. But I've had the joy of working with people who love doing that so we can leverage our skills for the greater good. There are many opportunities for the data-oriented coder. Of course, we should all be concerned about data integrity and coding what was done. But there are positions for people who want to slice and dice and interpret coded data. Registry programs (e.g., cancer, trauma, cardiac) often incorporate the use of codes and then some. The plus to being a registrar is that you usually become an expert in one particular area. For example, I know a cancer registrar who has been to enough tumor board meetings where cancer cases are discussed among physicians, she can effectively diagnose skin cancers most of the time (of course, the real diagnosis comes from a physician!).

Coded data is used by many - health departments, clearinghouses, universities, state hospital associations - and the list goes on. As the government becomes more concerned about outcomes of care and pay-for-performance in hospitals, there is a heavier reliance on accurate coded data. Independent companies like HealthGrades rely on coded data to compare the quality of healthcare among providers and report it to consumers. Someone is behind that data ensuring it's accuracy and interpreting it's impact and meaning. That could be you!

The "Why" Coder
I saved the best for last - well, in my opinion anyway. The "why" coder is the one who loves research and wants to know why. Why will Medicare not pay for a biopsy and an excision of a lesion done at the same time? Why does Medicare pay less for certain patients who have been discharged to a nursing home rather than home? What's the difference between two codes that at first glance appear to have identical code descriptions? Why can't men have pelvic pain?! And this is why I have trouble being a production coder. It's hard to produce when you keep asking why. Luckily, I am able to put my investigative skills to work and do research to build training materials for other coders - like production coders - so they can do their jobs efficiently. The best thing about the "why" coder is that it's free. You can learn just about anything you ever wanted to know about Medicare and their why's and not pay a cent. Of course, the price for accessing public domain information is the sheer amount of information you need to paw through to answer a single question - it can be several hundred pages.

So what's your passion? What kind of coder will you be? The opportunities are endless and we need all kinds!

Code Words for Getting Your Foot in the Door

It's the question I am asked most often as a mentor. "How do I get experience if no one will hire me without experience?" The unfortunate reality is that many employers aren't ready to assume the time, effort, and risk associated with hiring a newbie coder. But that doesn't mean that getting a job as a coder is impossible.

If you begin by looking at the job postings in your area for coders and then take a look around your live or virtual classroom at the number of students who will be looking for coding positions at the same time you will be, you can see that it just doesn't add up. In most markets there simply aren't enough coding positions for every coding student. But that doesn't mean there aren't other positions that will allow you to use and cultivate your skills and potentially align you for that coding position.

It can be especially tricky to make your way into a coding position in a hospital if you have no practical experience. The reasons for this are varied: some hospitals don't hire "newbie" coders, some hospitals have so many coding positions open that there are limited entry-level positions available, and some hospitals receive many resumes from both experienced and novice coders and subsequently hire the experienced coders. But this doesn't mean that the door is permanently closed - you just need to know how to nudge it open.

Consider HIM Positions
In the hospital setting, coding is often part of the health information management (HIM) department. While it can be difficult to get a coding position right out of school, it might be easier to get an entry-level position into an HIM department. This may mean assembling or scanning medical record documents, analyzing medical records for missing documentation, abstracting data for core measures and other hospital reporting needs, birth certificate completion, transcribing medical record reports, and working with registries (e.g., cancer, trauma, cardiac).

Many HIM departments promote coders from within when they show promise. Once you have your foot in the HIM department and are working solidly within one of these non-coding positions, though, it is no time to get lazy. Offering to do projects and work on teams that will expose you to coding and coded data is crucial. If you are interested in a coding position, you should never be shy about letting your supervisor know that that is your goal. If a coding position opens up, you need to make sure that HIM and coding management are aware of your interest.

The bonus to a position within HIM is that should a coding position become available, you will already be working for the managers responsible for hiring. You may also be exposed to other areas of health information and data management that you may otherwise miss if you follow the coding track only. The downside to a non-coding position within HIM is that you may still be overlooked for advancement to a coding position if an experienced, qualified external candidate applies for a coding job at your hospital. The dynamics of internal vs. external hires is very organization-specific, though, and there are always exceptions to the rule.

Try Billing On For Size
If you are interested in the billing side of coding, there may be opportunities in the billing (or patient financial services) department within a hospital. Look for positions that require coding skill by reading through the necessary skills. Dead giveaways include positions that require ICD-9-CM or CPT/HCPCS coding experience or "familiarity." Positions requiring "familiarity" with coding typically translate to entry-level positions. This may include working billing edit reports, processing insurance claims, or following up on insurance claim denials.

The benefits of working the billing end of coding are that you will become very familiar with the edit process and what won't be paid based on codes. This could potentially move into other billing-related positions including charge master maintenance. A disadvantage of working in billing is that should you be seeking a position as a coder within HIM, you won't be working for HIM's hiring managers and it could be more difficult to get the position you ultimately desire.

Develop a Plan
Whichever path you decide to explore, you should always take the time to develop a planned career path - even if that path deviates from your career map. Employers want to know what kind of position you are interested in so that they can assess your skill, how to get you where you want to go, and ensure that your career goals are in line with the organization. So take the time to develop a simply laid-out map of where you plan to be professionally within 1, 5, and 10 years.

Whatever path you decide to take, follow it with confidence and commit to learning as much as you possibly can in that position. It will take time to become skilled as a coder and like to many other worthwhile careers, you will get out of it what you put into it. Best of luck to you all!

Do You Want to Be a Coder?

A few months ago I held a forum for wanna-be coders and much of my presentation was devoted to hospital versus physician coding. By the time I was done, I had several people asking me how to choose between the two. This is an excellent question and one that you need to decide right off because how you proceed with joining organizations and networking will be impacted. First off, not everyone has the skill it takes to be a coder. I have, unfortunately, met and attempted to train a lot of people who just “don’t get it.” Coding requires a great deal of attention to detail that can be tedious to a lot of people. It’s also detective work – once you have all the details, then you need to be able to assemble them and make sense of them. And because these details come from medical record documentation, coders must understand medical terminology, anatomy and physiology, and disease process.

What Makes a Good Coder?

The first question to ask yourself is, do I meet the following criteria?

· Strong medical terminology, anatomy and physiology, and disease process knowledge,

· Ability to piece together clues logically,

· Strong attention to detail,

· Ability to work a full day in front of the computer without a lot of peer interaction,

· Common sense,

· Ability to research and seek out answers to questions,

· And good written and verbal communication skills for those times when you get to escape from your desk.

If you answered yes to most or all of these questions, then you are on your way. If you answered no to most of these, then you should reevaluate becoming a coder. Some things, of course, can be taught, such as medical terminology, anatomy and physiology, and disease process. Other things, like the strong attention to detail cannot be taught.

Hospital vs. Physician

Once you’ve determined that you want to be a coder, you need to decide which healthcare setting best suits you. There are coders for every healthcare setting, but the two major ones are hospital and physician. If you’ve never coded before, you may be wondering what the difference is. After all, there are only a few codebooks (ICD-9-CM, CPT, and HCPCS), so all you have to know is which book to look in right? Wrong.

Besides the coding systems, there are other differences. In a hospital, you are coding for the hospital resources, which include hospital overhead, staffing, supplies, medications, and anything else you can think of that a hospital provides to a patient that costs money. And remember: in most situations, doctors are affiliated with hospitals, not employed by them. On the physician coding side, you are coding for the physician’s time and effort as well as his office overhead. If the physician owns a surgery suite or otherwise utilizes supplies and medications, he may also bill for these items. He cannot, however, code or bill for items that were supplied by a hospital or surgical center where he performed a procedure. What it comes down to is, whoever paid for the item can code for it – this is where common sense comes in!

You may hear experienced coders and billers talk about professional versus technical coding. Professional services are those provided by the physician. So coders working for physicians are always billing the professional component. Technical services are those provided by hospitals or other facilities (e.g., ambulatory surgery centers, rehabilitation hospitals). There are some instances, however, in which a provider (hospital or physician) may bill for both the technical and professional component. For example, there are some physicians who are employed by hospitals. In these instances, the hospital can bill for both the technical and professional components and the physician is paid a salary by the hospital. Another example is of a physician who owns his own surgery center.

Another difference between hospital and physician coding is the information that is coded. In a hospital, the patient’s record is evaluated for the entire visit and all documentation is reviewed including physician reports and progress notes, orders, therapy records, operative reports, labs, and x-rays. In the physician coding setting, the coder is looking only at a particular physician and coding his part in the patient’s case. For example, although a patient may have been in ABC Hospital from June 4-10, if Dr. Smith saw the patient in consultation only on June 5, his coder can only code from his June 5 consultation notes.

The size of the practice or hospital also makes a difference. In physician offices, the coder is also the biller and, as such, must become very familiar with insurance billing regulations. Physician coders are generally also the ones to process and correct insurance denials.

In a hospital, coders are usually part of the health information management (HIM) department where they have easy access to the medical records. In addition to HIM coders there is a computerized system for assigning certain codes on outpatient cases automatically when charges are entered into the hospital’s computer system. These codes are linked to charges using a database that contains all of the hospital’s charges for every department. This enormous database is called the charge description master (CDM), or simply charge master, and codes assigned using the CDM are said to be hard coded. In contrast, the codes that are manually assigned by HIM coders are said to be soft coded. Hard and soft codes come together on the patient bill in the billing department, which is generally separate from coding. If there are any problems with the codes, the billers will send them back to the coders for correction. Once billed, the billers process the denials. So in the hospital, HIM coders are less likely to be familiar with the various insurance billing guidelines.

Finally, coding rules themselves can be different depending on the healthcare setting. One example is the application of the Official Guidelines for Coding and Reporting, which states that the first-listed (principal) diagnosis for a hospital inpatient is the reason established, after study, found to be responsible for occasioning the admission of the patient to the hospital. For physicians, though, the first-listed diagnosis is the reason for which he saw the patient for that episode. Another difference in coding guidelines is for the assignment of evaluation and management (E/M) codes. E/M codes were developed to report physician time and effort in examining a patient and determining the plan of care. Hospitals use E/M codes for outpatient cases, but have adapted the definition to be able to report hospital costs associated with patient care that are not separately reported with a procedure code.

What Type of Coding Setting Suits You?

So you need to determine the type of coding that best suits you. Do you want to work in a small office where you have control over the entire coding and billing process? Maybe physician coding is for you. Would you like work as part of a revenue cycle team and be able to view the patient’s visit episode as a whole rather than just one piece of it? Then maybe hospital coding is right for you. I can’t say which one is better, because I’ve found that people are inherently one or the other. I liken it to being either a cat person or a dog person – neither is wrong or right, it’s just what fits the individual. Can you be both? I think you can be both a hospital and physician coder, but I have yet to meet anyone who is really proficient at all areas of hospital and physician coding – there is so much out there! But that’s part of what I really like about coding… endless opportunities to learn.

Live in Colorado and want to know more? I will be soon announcing an August date for networking. We will meet in “pod forums” with three facilitators demonstrating how to code for physicians, hospital outpatient, and hospital inpatient. This is a great opportunity to see which setting is for you and network with the pros. This event will be FREE so stay tuned…