Total Instructional Time: 60 minutes - Maintenance



Martinez AAPC Annual Summer Picnic SeminarSummary:The Martinez AAPC Local Chapter is hosting their Annual Summer Picnic Seminar again! After last year successful picnic, where we tested the format with many of our members, we learned medical coding, earned CEU, networked, and enjoyed food and each other company over a nice picnic day!This year we are expanding it! Bigger and better! We will aim for 8 hours of various topics, hosted by your local chapter board members, and special guest speakers (from PAs, instructors and other coders)! This is a strict RSVP seminar! Seminar fee will include snacks, lunch, drinks, and materials for our seminar. (Regional Park fee is excluded and collected for parking at entry by Park Workers).Date: Saturday August 5, 2017Total CEU Request: 7 (1 unit per session)Timeline:8:00-8:30 AM: Registration8:30-9:30 AM: Session 1: Complex and Simple for Neurosurgery and Orthopedics9:30-10:30 AM: Session 2: Reading the Cards: So Many Numbers, So Little Time10:30-11:30 AM: Session 3: Pathology Coding11:30-12:30 PM: Session 4: It’s All in Your Head: Neuro- Cranial Surgery12:30-1:30 PM: Lunch1:30-2:30 PM: Session 5: Abscess Incision & Drainage2:30-3:30 PM: Session 6: E&M Coding3:30-4:30 PM: Session 7: Colonoscopies and Modifiers4:30-5:00 PM Closing and QuestionsPlease refer to each seminar below for more details submitted by each speaker(s):Seminar 1: Spinal Coding: Complex and Simple for Neurosurgery and OrthopedicsTotal Instructional Time: 60 minutesRequested CEUs: 1.0 CEUSummarySpinal surgery coding is intimidating for even the most experienced coder. With both the nervous and musculoskeletal systems to take into consideration, code selection can feel like looking for a needle in a haystack. What many don’t realize about spinal coding is that is really is organized well and into defined groups for codes. If you understand the procedures and anatomy you can code spinal surgeries. We’ll tackle laminectomies, arthrodesis, instrumentation, and grafting proving that surgical coding can be complex and simple at the same time.Speaker BioKaylyn Peterson, CPC is the current Education Officer for the Martinez CA Local Chapter. She works as a Coding Analyst for UCSF Medical Center with experience in surgical coding (Neurosurgery, Gastroenterology, OB/GYN Oncology and Dysplasia, Digestive) as well as E/M coding (Adult, Pediatric, Hematology, Oncology, Psychiatry, Surgical).AgendaIntroduction15 minutesWe’ll begin with an overview of the spine including the anatomy and physiology of the spinal cord, nerves, vertebrae, and intervertebral discs. While we discuss these areas important terminology for coding (space vs. segment, autograft vs. allograft, etc.) will be pointed out, allowing coders to more quickly and accurately select correct codes. A breakdown of where to find codes in CPT will be shown, such as where to find stimulator, laminectomy, arthrodesis, instrumentation, cage, and graft codes. CPT Code Selection15 minutesDiagnosis is imperative to choosing the right laminectomy code. We’ll go over what the most common procedures (laminectomies for decompression and lesion removal, arthrodesis with segmental instrumentation, and bone grafting) entail and how to use the diagnosis to find the best procedure code.Putting it All Together15 minutesAttendees will be taught how to report these different procedures together. With a few practice cases coders will be able to try their hand at coding a decompression, a lesion removal, and a complete spinal repair with instrumentation. While we discuss procedures we’ll address bundling and modifiers when certain spinal procedures appear together (when a laminectomy for decompression is in the same service as arthrodesis). Activity: Build Your Own Spinal Repair15 minutesThis game will test both A&P knowledge as well as coding. In small groups attendees will compete to build the most correct spinal repair. Each group will have color-coded blocks that represent the vertebral body, lamina/facets, and intervertebral discs. They will each have unique cases that require the spine to be repaired. Using other colored blocks that represent instrumentation, cages, and grafts the team must complete correctly then code their repair. Special attention must be paid to which level of the spine is being addressed, what parts were removed and/or reconstructed, and what instrumentation/graft was added. The teams will have a chance to explain their end product to the larger group and get feedback on their coding. Specialty CEU RequestSpinal surgery coding is highly advanced coding that is above and beyond what student and beginner coding students would be familiar with. In particular this type of coding is most useful for those with neurosurgical, orthopedic, plastic, and ambulatory surgical center experience. In participating in this session coders will need to already have a firm grasp of coding concepts as well as familiarity with anatomy and physiology in order to fully understand and grasp the core lesson. Participants will be expected to utilize CPT, ICD-10-CM, and HCPCS in order to complete activities.Seminar 2: Reading the Cards: So Many Numbers, So Little TimeTotal Time: 60 minsSummary:Understanding insurance cards in important for billing and coding. Because of the variances in carriers, groups, and plans along with requisite payer guidelines choosing the right way to sort a patient's insurance could mean the difference between getting paid or not. In this session we will be learning to decipher all the information packed on insurance cards and understanding why it's an important skill for medical billing.Speaker: Katrina Peterson, CPC-A, & Chris Lam, CPC, CASCCPresenter BioKatrina Peterson, CPC-A. Works at SF Bay Pediatrics as an Eligibility Clerk. She has experience billing with commercial insurance plans and patient relations regarding insurance in private practice.OutlineWhy do we need to know how to read an insurance card? ( 10 mins)Different types of insurance Common insurance and billing terminologyPayer guidelines for billing and codingWhat are the common elements of a card? ( 15 mins)Payer namesPlan names What do all these numbers mean?Alternative terminology for elements such as subscriber ID, etcTips and Tricks ( 15 mins)Print and Issue datesIPAsOut of State plansBirthday RuleDivorces and DependentsBest office practices for keeping insurance information updated and accurate Sorting activity ( 20 mins)Teams will be asked to pull information from mock insurance cards and sort it into various categories such as Plan ID and Network. For every incorrect sorting, they will have to be hit by or dodge a water balloon.Seminar 3: Pathology CodingTopic summary:Surgical Pathology is the study of tissues taken out of a patient during a surgery to diagnose a disease and determine treatment. Surg Path includes 2 types of specimens, biopsies and surgical resections. This also includes review of foreign materials removed during a surgery.Speaker:Faye Hoang, CPCSpeaker bio:Faye received her CPC in 2008, since then, she’d coded for the department of Pathology at UCSF for 4 years before becoming an educator and internal compliance analyst for the unit in 2012.Total Time: 60 MinsAgenda:Briefing: 15 minsWhat is Surgical Pathology?Gross vs Biopsy vs resections?Main content: 30mins-Gross review only???????????-Biopsy coding levels, per part-Resections coding levels-Single specimen-Multi-specimen bundling rules: Laryngectomy, Whipple, mastectomyApplication: 15 minsThere will be a quiz and discussion of the final codes for 1 simple and 2 complex casesSeminar 4: It’s All in Your Head: Neuro- Cranial SurgeryTotal Instructional Time: 60 minutesRequested CEUs: 1.0 CEUSummaryThe brain is unquestionably the most complex and mysterious organ in the human body. It’s understandable that “brain surgery” has become synonymous with anything difficult. The truth is that brain surgery is really a small set of codes, and with some anatomy & physiology as well as medical terminology knowledge code selection can be relatively simple. We’ll go over anatomy & physiology, terminology to know for coding, and the most common types of surgery: twist drills, burr holes, craniotomies/craniectomies, and deep brain stimulators as well as use of technology such as stereotaxis, endoscopes and operating microscopes.Speaker BioKaylyn Peterson, CPC is the current Education Officer for the Martinez CA Local Chapter. She works as a Coding Analyst for UCSF Medical Center with experience in surgical coding (Neurosurgery, Gastroenterology, OB/GYN Oncology and Dysplasia, Digestive) as well as E/M coding (Adult, Pediatric, Hematology, Oncology, Psychiatry, Surgical).AgendaIntroduction: The Brain and the Skull15 minutesTo start coders will go over some A&P specific to the brain and skull including terminology that will be necessary to code. Some of areas we’ll discuss include:Cerebrum: lobes, gyri, and sulciTentorium: supratentorial vs. infratentorialMeningesVentriclesCerebrospinal FluidCerebrovascular vesselsElectrical conduction in the nervous systemSkull Base ApproachesNext, we’ll discuss procedure specific topics:Twist drill vs. Burr holeCraniotomy vs. CraniectomyPossible otolaryngology approaches to the brainStereotaxis (aka Stealth or Brain Lab)Operating MicroscopeLeads vs. GeneratorsCranioplastiesCPT Code Selection15 minutesWe will stick to a small selection of the codes that make up these services. We’ll go over:Craniectomy for removals: neoplasms, lesions, meningiomasCraniectomy for epilepsyTwist drill, burr hole, and crani for drainage or evacuationCerebrovascular procedures: arteriovenous malformation repairs and aneurysm repairsDeep Brain Stimulators: staged procedures, implantation services, revisions and removalsModifiers: staged procedures, surgeries within a global period, and separate proceduresPutting it All Together15 minutesWith a few cases to work on as a group, attendees will get a chance to code these procedures:Craniectomy for malignant neoplasm removal with stereotactic guidance and operating microscopeCraniectomy for cerebellopontine angle tumor removalSimple and complex cerebral aneurysm repairDeep brain stimulator lead and generator implantationAttendees will also get an overview of diagnosis coding, including use of pathology reports to get the most specific diagnosis.Activity: Neurology Obstacle Relay15 minutesThis competitive game will test teams’ knowledge of anatomy and physiology, medical terminology, and coding. First teams must designate participant order as each person will have to confront a new obstacle in order for the team to advance. Instructors will be on hand to judge each team’s progress and aid if necessary. As each stage is advanced teams will collect scenario pieces. At the end of the course they must put their scenario together and correctly code it in order to win.Obstacles include:Pin the Lobe on the Cerebrum: Correctly pin all the lobes of the brain in the correct layoutSupratentorial/Infratentorial: Given a set of excision locations, correctly sort which are supratentorial and which are infratentorial by tossing bean bags into labeled holesSimple or Complex Aneurysm: Given the repair criteria players must play tic-tac-toe with the instructor to make a complex aneurysm repairFind the Modifier: With a scenario in hand sort through a bucket of water balloons labeled with modifiers to find the correct one. Each incorrect one has to be thrown at a team member.Specialty CEU RequestNeurosurgery of this nature is not for beginners. Attendees will need to have working knowledge of nervous system and musculoskeletal system A&P and medical terminology. While it is not a requirement, surgical experience will be a benefit in understanding the presentation material and being able to complete the activities. The presentation will include specific information regarding NCCI Edits, bundling, and medical necessity documentation, which can benefit coders who work in other specialties. Because of the advanced nature of this code set, specialty coders are encouraged to attend. Seminar 5: Abscess Incision & Drainage Speaker:Speakers: Veronica Caballero, PA, Chris Lam, CPC, CASCCPresenter Bio:Veronica Caballero is a certified and professional Physician Assistant (PA) since 2014 and has been working with Freemont Urgent Care Clinic since 2009. She has various clinical experience through various cares such as trauma to management of diseases. Objective: Learn about common urgent care complaints, cellulitis and abscesses. Gain knowledge about incision and drainage procedures which is a treatment for abscesses. Interpret chart notes and bill procedures accordingly. Finalize billing and coding for a problem oriented exam - abscess involving incision and drainage. Presentation 35 min chief complaint of a swollen bump "bug bite" on the left lower buttock subjective complaints - red, swollen, tender x 3 days objective complaints - physical exam findings 3cm by 5 cm area of induration, however not yet fluctuant. Review terms. cellulitis vs abscess vs cyst assessment/plan - abscess not ready for incision and drainage, warm compresses, recheck 2 days Discuss coding involved with this visit Patient returns for a RECHECK 2 days later ...objective findings - abscess is now FLUCTUANT and ready for I&D discuss I&D procedure, sterile tray, instruments involved, anesthesia etc. gauze packaging, wound care, f/up. Discuss coding involved for I&D procedure Patient returns 2 days later for packaging removal plus further drainage and re-packing. Discuss coding for follow up. Final discussion start to finish for I&D of abscess with procedure codes etc. Activity 25 min assign multiple groups of 5-6 people each group given a stack of cards (mixed up) cards contain information regarding SOAP note, abscess I&D procedure start to finish, plus coding groups then collaborate to create a time-line of the events, add the codes in the appropriate spot, and re-create the visit - 20 minutes the team that successfully places the cards in order wins a prize Seminar 6: E&M CodingPresenter: Lillian Galindo-Bryson, CPCBIO:Moved to California 10 years ago. Background in Business. Worked in the health field 34 years ago in a Nephrologist practice. Got certified in 2010 and started teaching the medical program at Martinez Adult Education in 2011. Run different positions on the board from 2011 - 2014...ending each term as President of Martinez Chapter.Summary: E/M is essential for coders as students and work professionals. In this class we will learn advanced elements of the key components, contributory factors, and documentation in an audit setting. Practical exercises will help coders learn how to distinguish between levels and make audit-proof choices. I spend the last six years training students for the AAPC certification exam. Will give complete setting on E/M information. The level of difficulty...HIGH... Total Time: 60 MinsAgenda5 min - Introduction and explaining the importance of knowing your coding? ? ? ? ? ? ? ? books and guidelines15 min - explaining E/M in a classroom: Key Components, Contributory Factors and how to find them in documentation5 min - problem areas: different interpretations in HPI and MDM15-20 min - working on an exerciseSeminar 7: Colonoscopies and ModifiersSummary:Colonoscopies are commonly performed outpatient both for diagnostic or therapeutic cases. We will discuss the techniques during preparation and performing the colonoscopies. Then we will discuss how the coding depends on how far the doctors exams, what he does, and how to apply modifiers for various different situation (incomplete exams, conversion of screening, and surveillance).Speaker Bio:Christopher Lam is a UCSF Medical Analyst Coder for the Faculty Practice Revenue Management department. He works with in various 26 multi-specialties at UCSF. From E&M and procedures in Psychotherapy, OB/GYN, Breast Care, Oncology, GI, etc. He is also the current President of the Martinez AAPC Local Chapter.Agenda15 mins: Clinical BriefingGo over what a Colonoscopy is. How the PT prepares for the colonoscopies. And the different techniques the doctor performs colonoscopies.30 mins: Colonoscopy CPT and Modifier CodingWe will go over:- The difference between screening and therapeutic coding. - The checkpoints of a complete colonoscopies and modifiers for incomplete colonoscopies- The different techniques of therapeutic:Cold, Hot, Snare, Ablation, Submucosal Resection- The conversion of Screening to Therapeutic cases (33 vs PT modifiers)15 mins: ApplicationWe will have a quick activity to quiz and apply different CPT codes and modifiers. Each group will give a situation and it's the job of the group to discuss and code the case. We will go over each group’s situation and answer.Specialty Coding Request:CGIC, CASCC, COCSeminar 8Summary:Coding, definitions, why we need certain medications. I will do some matching, definitions, did you know why you need a certain medication for a particular diagnosis.Why you may need a certain test ran for certain diagnosis.I will try to think of a fun game to practice it. Maybe a doctor and patient I will give them an example of what Dx? or test to use and the rest can code it.Code the Dx or test only.CPT and ICD 10 books needed. ................
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