Coding Corner: Week 2
As I wrote this title, I found it hard to believe it’s just been two weeks! But it’s true. I got my books right around Christmas time and turned in my first assignment December 28, just two weeks ago. How time flies. In case you missed the first post on the Coding Corner columns, you might want to take a quick read.
My course is broken into four modules, so I am in Module I. Yesterday, I turned in my 13th test and am now working on #14. So far, so good. My grades so far have me at a 99% average, with most of them being 100, although I do have three where I missed one question and got a 97%. So let me just share my feelings and observations so far.
First, while I do recognize that module I is no doubt easier than what’s coming, this module is really quite easy. Now, I don’t think it would be as easy if I were starting without the medical knowledge. Let me explain what I mean by that. I’m still at the point where we are required to show every step we take, every word we look up, etc. And yep, my race horse personality still isn’t crazy about that. 
You generally find the code for a diagnosis under the “main” word. I think that’s something that’s easier for someone who has done clinical documentation because we already know what that main word is when we read a diagnosis. For example, if I look at the diagnosis, one from the exercises in my books, I see this: Dupuytren’s contracture. I know that contracture is going to be the main word, so that’s where I start. Yep, found it. Now to be certain, I do also need to look up Dupuytren’s, and yep it’s there too. Now that I have a code, 728.6, I need to go to the tabular section of my ICD-9 book and be sure it matches. Sure enough, that says “contracture of palmar fascia,” and Dupuytren’s contracture is listed under that section.
Now let’s do one that’s not so easy, unless you have an understanding of medical language. Kanner’s syndrome. Okay, what to do there? Yes, we can start with syndrome. And you would find it there, with a code and a note to see “autism.” If I have an understanding that Kanner’s syndrome (yea, these code books still aren’t dropping the apostrophe “s” with eponyms!) is a form of autism, I can also look up autism and find it there.
Sometimes you have to know what’s expected. For example, if all you are given is a baby’s weight, you need to have an understanding of what normal weights are. If all you’re given is that a child is a “late walker,” you need to understand that fits under developmental milestones. A child who isn’t gaining weight would be a clue to look under those milestones, or perhaps under failure to thrive.
What I believe is that we already have much of that knowledge. That makes it easier to think through where to find the codes for a particular diagnosis.
Oh then there’s those 4th and 5th digits. Sometimes this can be challenging. For example, let’s say I have a baby who was born, just one baby. Okay so that’s a livebirth, which fits under V30. But wait, V30 days it’s a 4 digit code. Okay so now what do I need to know for the fourth digit? Well for this one, I have to determine where the baby was born: 0 if in a hospital (which then requires a 5th digit), 1 if before admission to the hospital, and 2 if outside the hospital and not hospitalized. So if a baby was born at home and not hospitalized, it’s V30.2. What about that baby that was born in the hospital? Now we need a 5th digit! So it needs a 0 if delivered without mention of cesarean section and a 1 if delivered by cesarean section, so V30.00 or V30.01. Yes that part can be easy to miss if you don’t pay close attention.
A word of caution: As I understand it, not everyone goes through this as fast as I have been able to so far. With any education, it’s critical that you absorb the materials. Sometimes, even for an MT, that means going back and reviewing the terminology or the anatomy for the section you are doing. I happen to be at a place now with quite a bit of time to devote to this which is allowing me to move pretty quickly. I also feel a need to do that so that I can do the credentialing exams and decide what to do from there.
So there you have it, two weeks of coding courses! Any questions? Anyone else giving it some thought? I’d love to hear your thoughts.
And for now, I’m off to work on neoplasms, my topic for the day!
Related posts:
- Coding Corner Week 3 and a Great New Tool for MTs!
- Coding Corner
- Coding Corner Update
- Coding Corner Update
Tagged with: Coding Corner • continuing education • future of medical transcription
Filed under: Coding Corner
Like this post? Subscribe to my RSS feed and get loads more!
Congratulations! From where are you taking your coding course? Is it a do at your own pace type of distance learning?
[Reply]
Kathy Reply:
January 11th, 2012 at 9:18 am
Carla, I’m doing the program at Andrews, which you can read about in my first Coding Corner post. It’s “kind of” do at your own pace, although there is a waiting time for exams to arrive because they have to send the next one out after I complete one.
[Reply]
Yes, I have given it some thought, but my concern is finding a job and finding a job without the usual job experience required. So, I guess I’m not completely sold on coding yet. In my area, I have not seen any coding positions posted on the job boards.
I have applied for 4 jobs recently in hospitals. The only requirements listed are medical terminology and previous experience working in a hospital environment. I have both. (OK, so the hospital experience is a while back. I thought it would still count.) One of the jobs listed also required the ability to transcribe. All I get are emails saying I don’t fit the position.
The downside of being a medical transcriptionist for 30+ years and working at home for the majority of those years is that apparently the people who do the hiring feel that’s all I’m capable of doing. I’m just someone who can type.
[Reply]
Kathy Reply:
January 11th, 2012 at 9:19 am
Lisa, I would be on the phone to the HR department and ask more questions at those places you have applied! Sometimes it just means we have to take the bold steps to get in front of someone and make our case. I also stopped using the words “medical transcription” and started talking about my experience in “clinical documentation.” That has meant a very different response for me.
[Reply]
I’ve thought about coding myself and am very interested in your journey, Kathy. Some of my clients are putting the coding right into reports, so that interests me. One of the docs always cuts off the end, but I’ve been having fun researching. This interests me.
Regarding the “clinical documentation” term. Honestly, aside from the reaction I receive from others using that term, I feel different just saying those words. It better represents what we to a greater extent than MT. To boot, people’s eyes don’t glaze over (and I no longer have to wonder what they’re thinking because transcriptionist is no longer in my vocab, lol).
[Reply]