IDENTIFYING
TRUSTWORTHY SOURCES
IN MEDICAL CODING
By: Laidy Diana Martinez,
CPC, CPB, CPMA, CGSC, CGIC, CASCC
For more than fourteen years, I have been dedicated to a fulfilling
career in the healthcare sector. Throughout this journey, I have had
the opportunity to explore various specialties, deepening my
understanding of the complexities of revenue cycle management.
Currently, I hold the position of Coding Supervisor at Hoag Health
System, where I leverage my expertise in billing and coding to
mentor and lead my team in the coding department.
In addition to my role at Hoag, I take great pride in my position as a
Teaching Assistant for the AAPC VILT program. Here, I guide
students as they prepare for their certification exams, sharing the
knowledge and wisdom I have accumulated over the years to
support their success. Furthermore, I am honored to serve as the
2024 Treasurer Officer for the Orange/Irvine AAPC Chapter and
actively contribute to the AAPC's Billing Advisory Committee.
My primary motivation stems from the satisfaction I derive from
helping others succeed. Assisting and motivating professionals in
achieving their goals within the healthcare industry is truly fulfilling
for me, and it remains the driving force behind my professional
dedication and enthusiasm.
AGENDA
01. IMPORTANCE OF
RELIABLE SOURCES
05. SAVE THE SOURCE
02. CHARACTERISTICS OF
RELIABLE SOURCES
06. RECAP
03. REALIABLE SOUCES IN
MEDICAL CODING
07. QUESTIONS
04. ADDITIONAL SOURCES 08. CONTACT INFO &
REFERENCES
DISCLAIMER
This presentation is not intended to constitute
legal advice – it is for informational and
educational purposes only. All comments,
opinions, and observations are those of my own
interpretation and do not represent official
positions or opinions unless specifically noted.
Although the information presented has been
carefully checked and researched for accuracy
and completeness, the speaker/author does not
accept any responsibility or liability with regard
to errors, omissions, misuse, or
misinterpretation.
This presentation does not replace the CPT,
HCPCS, or ICD-10-CM code books or other
appropriate coding authorities.
01.
IMPORTANCE OF
RELIABLE SOURCES
IMPORTANCE OF
RELIABLE SOURCES
The importance of reliable sources
cannot be emphasized enough.
Accuracy
Compliance and Regulations
Patient Safety
Insurance Reimbursement
Quality Assurance
Efficiency
Ethical Responsibility
Reducing Risk
Audit Preparedness
02.
CHARACTERISTICS OF
RELIABLE SOURCES
REPUTABLE
Medical Professionals
Healthcare Institutions
Professional Organizations
CREDITABLE Academic Institutions
Industry Experts and Consultants
CMS
AHA
AMA
Coding Manuals
WHO
HHS
Coding Software Tools
03.
REALIABLE SOUCES
IN MEDICAL CODING
The Rabbit Hole in
Healthcare
The expression "going down the rabbit hole"
is often used figuratively to describe a
situation where someone becomes deeply
engrossed or immersed in a complex or
intricate topic, often to the point where it
feels like they are exploring a never-ending
maze of information.
Complex cases
Extensive Research
Documentation Review
Code Selection
Time-Consuming
Importance of Accuracy
Continuous Learning
NCCI
MCD
MLN
MACs
CERT
OCR RADV
AHRQ CHIP
SAMHSA IOMs
OIG
CDC
FDA
HRSA
CONFUSED?
NHCS LET’S CHECK SOME SITES
04.
ADDITIONAL
SOURCES
AAPC
AHIMA
JAMA
X12
NUCC
NAIC
NAMAS
AAP, AAFP,
ETC THE WORLD AT
YOUR FINGERTIPS
05.
SAVING &
ESTABLISHING REVIEW
INTERNAL STORAGE MAGAZINES
SAVING
THE
SOURCE
EXTERNAL STORAGE APPLICATIONS
CLOUD BOOKMARKS
DIGITAL NOTEBOOKS MOBILES
07.
RECAP
R E
REVIEW THE INFORMATION EVALUATE THE SOURCE
Regularly review and revisit Prioritize trustworthy sources from
information to reinforce your reputable organizations and experts in
understanding and stay up-to- the field to ensure the accuracy of the
date in this field. information you use for coding and
documentation.
CREDIBILITY OF THE ACQUIRE MORE PERFORM BETTER
INFORMATION KNOWLEDGE Dedicating the time to
Always seek information from Continuously invest stay current will help
credible and authoritative in your professional you improved your
sources. development and accuracy and
knowledge base. proficiency in the field.
C A P
07.
QUESTIONS
HAVE MORE QUESTIONS?
REACH OUT
LAIDY DIANA MARTINEZ
[email protected] REFERENCES
AMA:
https://www.ama-assn.org/practice-management/cpt/setting-record-straight-proper-use-modifier-25
CMS:
NCCI:https://www.cms.gov/medicare/coding-billing/ncci-medicare
MACs; https://www.cms.gov/medicare/coding-billing/medicare-administrative-contractors-macs/who-are-macs
CERT: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/comprehensive-error-rate-testing-cert
RADV: https://www.cms.gov/data-research/monitoring-programs/medicare-risk-adjustment-data-validation-program
CHIP: https://www.medicaid.gov/chip/index.html
IOMs: https://www.cms.gov/medicare/regulations-guidance/manuals/internet-only-manuals-ioms
HHS:
HealthIT: https://www.healthit.gov/
AHRQ: https://www.ahrq.gov/
SAMHSA: https://www.ahrq.gov/
OIG: https://oig.hhs.gov/
CDC: https://www.cdc.gov/
REFERENCES
HHS:
FDA: https://www.fda.gov/
HRSA: https://www.hrsa.gov/
NCHS: https://www.cdc.gov/nchs/nhcs/index.htm
AHA Coding Clinic:
AHA: https://www.codingclinicadvisor.com/?utm_source=externallink&utm_medium=ahima&utm_campaign=2023-ghealth?
utm_source=externallink&utm_medium=ahima&utm_campaign=2022-ghealth
AAPC: https://www.aapc.com/
AHIMA: https://www.ahima.org/
JAMA: https://jamanetwork.com/
X12: https://x12.org/codes/claim-adjustment-reason-codes
NUCC: https://www.nucc.org/index.php/1500-claim-form-mainmenu-35/1500-instructions-mainmenu-42
NAIC: https://content.naic.org/state-insurance-departments
NAMAS: https://namas.memberclicks.net/
SPECIALTY ASSOCIATIONS: https://federationdirectory.ama-assn.org/federations
