My OCD Song
Helloé Hello Mr. Neal. How are you todayé I'm good. Where's the rest of the groupé Oh it's just you. I'm the groupé Yes but don't worry, I don't need anyone else. That Picture frame Those Hoodie Strings
They are driving me insane Unequal pizza slices Fonts of different sizes It's more than I can take Missing parenthesis Uneven capris Googling quot;askewquot; Bags opened the wrong end
Should be recognized as a sin, Along with An unsolved Rubik's cube I gotta make things right Make it the way it's supposed to be It's my OCD Toilet paper facing inwards Unsynchronized synchronized swimmers A closet thats not organized
Pills removed out of sequence Sideburns that are not even That one rebel mini blind I gotta make things right Make it the way it's supposed to be It's my OCD Mr. Neal, how's everything goingé Fine.
Would you like to take a breaké Yeah Actually that'd be Great. I hope you're hungry I've prepared some snacks for you. Enjoy And I gotta make things right Make it the way it's supposed to be It's my OCD baby I gotta make things right
Make it the way it's supposed to be It's my OCD Alright we're all done you're free to go. Mr. Nealé Mr. Nealé Can I come back tomorrowé.
The 2013 AAPC Conference Review
That was as far as the main content. For anyonethat wants to stay on, Alicia is going to regale us with some of the wonderful thingsshe learned in the AAPC 2013 Conference sessions. Let me tell you, she found some really goodtips with networking from people so it's definitely worth hanging on if you guys have the energy.Alicia, take it away. OK. What I learned from talking with Alicia andit was about some of the coding areas, or I should say, elective surgery, was some ofthe things that you were talking about in some of our tutorials. You can check our YouTubetutorial on that one. So that's a good one for
me who's involved always with lead generationfor companies and such. Right. The one thing that they talked aboutthat. there's a couple of things that really stuck out in my mind, but one of the thingswas for the future with all the healthcare changes, the companies that are making moneyare surgery centers. Things like, procedures that insurance doesn't pay for, let's saythat for example. Because when insurance is paying, they're ultimately dictating how muchmoney they will pay ultimately ,especially government plans, okayé But the ones thatdon't get dictated to, LASIK surgery for your eyes, like gastric bypass surgery and stuff.That only got an ICD9 code or a CPT code
like in 2010, and they're just barely startingto pay, they're really not. Like sleep procedures; they had to pay for that, out of pocket. Otherprocedures that they have to pay for out of pocket, plastic surgeries and stuff. So, if you want to work for somebody thatyou know is going to have money, go to surgery centers, go to the specialty s. Theyusually have fantastic waiting rooms because there's competition there, and their employeesget paid well, they get bonuses. Starting with that CPCH that's geared just for thattype of coding. That is going to be really interesting to see what happens in the futurewith that. Another thing that really stood
out in my mind is a lot that was done on riskadjustment, and it falls into the HCC coding that I'm doing. The tide is going to turn in the next fewyears that we're not going to. the 's aren't going to be paid via what they do tothe patient like CPT codes, they're actually going to get paid by how sick the patientis, and that's what HCC coding is all about. It's Medicare advantage, and they give the an X amount of money by. if the person has diabetes, they get this much. If theyhave diabetes and kidney disease they get X and Y, and if the person has neuropathyand on top of that, they get even more money.
So you're going to see some changes with ICD10and that's real interesting, so I'm excited about that because I'm an ICD9 junkie. Now, the heads up about ICD10, again, likeeverybody has been saying, know your anatomy and physiology. I did a couple of classeswith that and they gave some examples of how specific it is, and you're going to need toknow some things that you might not have known before. Now, can you learn this on your ownéYes you can. Is it going to be easier to take a quick course and beef up your skillsé Yesit is. So, you might want to consider that before ICD10 comes around.
There were a lot of fears still about ICD10and doing that certification, they're telling, they're stressing it, you need to do ICD9.Get certified in ICD9 first because ICD9 is not going away. If you have Workman's Comp.and they give a list of three or four other things, they're not using ICD10; they'regoing to stay in ICD9. Now, let's say a person goes in to the and they have a heart transplant and it said. and we're in full mode of ICD9; but the dategoes by, there's no leeway, you switch to ICD10. So, you have to able to code an ICD9and ICD10. Did they really push thaté No. ICD9 is going to help you with ICD10 becauseyou look up everything the same. Everything
Gestational Diabetes Medical Coding Medical Coding Tutorial
Laureen: Yeah. Alright, now I think we goback to your gestational diabetes. Alicia: Q: I want to code 648.8 for gestationaldiabetes. I do NOT need a 250 code with that, correcté Because 250 codes EXCLUDE gestationaldiabetes. Righté Dawn A: She's right. Let's see here, 648.8 is thecode for gestational diabetes. If you look at 648.80 abnormal glucose tolerance, complicatingpregnancychildbirth; unspecified episode of care. If you go to 250.00 which is yournormal type II diabetic code, you will see that it has an Excludes and there's an Excludesfor several things but I got rid of everything except for gestational diabetes. It even tellsyou 648.8 is where you want to go to look
for the proper code if it's gestational diabetes.Now, that being said, I went ahead and got some more information on gestational diabetesbecause sometimes if you understand the disease process it will help you to find the codesand to understand that gestational diabetes is nothing like type I or type II diabetes.It is diabetes that is only when you're pregnant. So, they have high blood sugar, during pregnancyand that's it; as soon as the baby is born it just goes away. They have found that 18% of women in theirpregnancies get gestational diabetes, and you can have it at one time and not have itanother. They don't know the cause, but they
do know it has something to do with the placentathat supports the baby when it grows; that hormones from the placenta help the baby develop,but these hormones also block the action of the mother's insulin in the body, so thisproblem is called insulinresistance, and it makes hard for the mother's body to use theinsulin so she may actually produce three times as much insulin as needed. Gestational diabetes starts when your bodyis not able to make and use all the insulin that your body is producing for the baby andthe mother, and without enough insulin the glucose can't be turned into energy. Therewas a great website that this came from, but
ultimately what happens is that glucose buildsup in the blood and it just gets too high and you have hyperglycemia. You can, a lot of times, just regulate thatinsulin by diet and exercise, but sometimes it's bad enough that you would have to takea medication, take a pill maybe; but there are incidences where women actually have totake insulin injections. I don't know how common that is, but I do know that when theytest you and they do that glucose tolerance test, they do it about the time, it's likea 20some weeks, because that's whenit usually exhibits itself.
Again, as soon as that baby is born, yourbody goes back to normal and you may never have problems again. It doesn't matter whatsize you are. You can be a very thin, healthy, never have had a history of sugar problemsin you or your family, or you can bea big woman and rather unhealthy. It just doesn'tmatter. It has more to do with the placenta, and there's nothing that you can do to stopit either, that it's either going to happen or it's not. That being said, it is diabetesbut it is diabetes that comes on and goes in relation to the pregnancy, so it's notcoded 250.00, it is actually coded in the 600s.
Laureen: Alright, very good. Alicia: And that's a great website there bythe way. Laureen: Why don't we go back to this one,just some followup questions if you didn't mind, and then we'll let Boyd merge them together.Sorry, Boyd. Alicia: Is that the one, is someone sayingsomething about the third degreeé I saw that question pop up. Let's see here, if you goand you look up that code which is the Laureen: What's the question so that everyonecan know what we're trying to answeré Alicia: Q: They were wanting to know on thefirst scenario, if a person has a first degree