Here are some examples of abnormal findings that could be coded during a routine preventive exam: - Lump or mass found on physical exam - Abnormal lab or test result (e.g. high blood pressure, abnormal pap smear) - Enlarged lymph nodes - Heart murmur - Skin lesion or rash - Joint swelling or pain The key is that it was an unexpected or unintended finding, not the reason for the exam. Routine screening exams are not coded if they are normal. Only code an abnormal finding if it is documented.

1. Certification Coaching
Q & A Webinar
October 2015

2. This Month’s Q & A Webinar Agenda: 90-120 min
II: Q&A from our Instructors
● Chandra: A Day in the life of an RA-HCC Coder
● Alicia: ICD Gastroesophagitis
● Alicia: ICD Pregnancy with Drug Use
● Alicia: ICD Degenerative Lesion
● Laureen: Modifier, Global and Bundle
● Team Discussion: What’s the Scoop on ICD-10?
I: Introduction
● Why stay?
● Where is everyone from?
● Recent CCO Graduates/ You Too?
● Announcements and Course Updates
IV: Your Questions in the Chat
III: Close - @ 90 min-’ish’
● Wrapup
● Drawing
● CEU Certificate Download Link
Ask Along the way in the Questions box.
NOTE: We can’t answer every question.
If your question isn’t selected,
post it on our forum where fellow
coders can help:
http://www.cco.us/forum/

3. Why Stay To The End?
Giveaway!
Free Drawing of Your Choice of 1 of the following:
Blitz Video Package | 2 CEU Webinars | 1 Hour Session with Laureen or Alicia
and...
Your AAPC CEU link for 1.5 CEUs

4. CCO Monthly Q&A Webinar CEU Changes
Webinar Attendees: Accessed within 24 hours
● * $5 - Worth 1 to 1.5 CEU per meeting
● Webinar Attendees: Accessed after 24 hours
● * $10 - Worth 1 to 1.5 CEU per meeting
Replay Club Members:
* $0 - Included in your membership ($19.95
month)
http://go.cco.us/webinar-replay-club
New Webinar CEU Pricing Starting NOVEMBER 2015
Don’t need CEU’s? Continue to attend the CCO webinar for free!

5. First Webinar With Us?
Poll
How many CCO webinars
have you attended?

6. CONGRATULATIONS to...
Nadine Colassaint 9/29/2015 Passed CCS-P
Candace dos Santos 9/23/2015 Passed CPC
GIGI WILLIAMS 9/19/2015 Passed CPC
Janice Newman 10/7/2015 Passed CPC
Jennifer Wood 9/19/2015 Passed CPC
Karen Thomas 9/19/2015 Passed CPC
Kathleen Carroll 10/2/2015 Passed CPC
Kristi Mathews 10/8/2015 Passed CPC
Kristy Parker 9/26/2015 Passed CPC
Lisa Colbert 9/17/2015 Passed CPC
Michele Krieg 9/23/2015 Passed CPC

7. CONGRATULATIONS to...
Rhonda Crouch - TN :-) 9/19/2015 Passed CPC
Stacy Amick 9/17/2015 Passed CPC
Sue Aszmann 9/26/2015 Passed CPC
Vicky Taylor 9/17/2015 Passed CPC
Sandhya Semendy 9/26/2015 Passed CPC
Nikki Kimmy 10/16/2015 Passed COC Exam
Kelly Barnett 10/10/2015 Passed CPC Exam
Jennifer Dixon 10/19/2015 Passed CPC Exam
Carolyn Jeffrey 10/20/2015 Passed CPC Exam
Darlene Britton 9/26/2015 Passed CPMA
Schuyler Connell 10/00/15 Passed CPMA Exam

8. CONGRATULATIONS to...
Stacey Amick 10/9/2015 Passed ICD-10 Assessment
Sally Puff 10/10/2015 Passed ICD-10 Assessment
Tammy Jones 10/12/2015 Passed ICD-10 Assessment
Darlene Batcher 10/14/2015 Passed ICD-10 Assessment
Anna Kelleher 9/28/2015 Passed ICD-10 Assessment
Ashley Enciso 9/26/2015 Passed ICD-10 Assessment
Michele Krieg 9/23/2015 Passed ICD-10 Assessment
Nydia Robles 9/30/2015 Passed ICD-10 Assessment
Dawn Crotty 10/9/2015 Completed PBC & MTA course
Elizabeth Castellanos 9/15/2015 Completed PBC course
Elaine Haddad 10/20/2015 Completed PBC course
Laura Bissell 10/19/2015 Passed CPC Exam

9. Interested In the CCO BLIZZARD for 2016?
Attend in Person (Tampa FL) or Virtually from Your Home Computer
Sign Up for Event Notifications:
LINK: http://go.cco.us/blitz-event-early-bird
CPT | ICD-10-CM / PCS | COC | CIC | RA | CPT Update
Sessions Starting: Thursday 12/3/2015 > Tuesday 12/8/2015
Plus, you'll also be eligible for a nice Early Bird discount!

10. So what are our Students saying about us?
TESTIMONIALS about the CCO CPC Blitz Videos
Live CPC Blitz Attendee
“ I would recommend this course because it really
gives you an in-depth knowledge of what to expect
for the test. It goes through each section,
highlighting each particular topic or subject that
will be on the exam. She goes very detailed into
what to expect, what not to expect, which
questions will be and which not to be. I think most
of all, the fact that she also mentions the real world
coding experiences gives me that knowledge of
knowing where to go back in my book and knowing
how to code it.”
Maritza Molina, CPC
Sign Up for Blitz Event Notifications:
LINK: http://go.cco.us/blitz-event-early-bird

11. The CCO Bookstore!
● The Instacode Institute
● AMA
● AAPC
● Cengage
● Elsevier
CCO bookstore -- now available from our CCO partners:
Go to: http://store.cco.us/

12. !! NOTICE !!
CCO is looking for Subject Matter Experts in
Inpatient Facility Coding
We are looking for experts for additional
content development (CIC/CCS),
practice exam development,
student coaching, and
generalized SME tasks.

13. Is this YOU???
Candidates need to have experience in
Inpatient Facility
Coding/Billing/Compliance, etc.
(CIC or CCS certification preferred)
------------------------------------------------------------------------------------------------------------------------------
If you are interested,
please message Chandra - chandra@cco.us
------------------------------------------------------------------------------------------------------------------------------
>>> put "CIC/CCS subject matter expert"
in the subject line please and provide a
short synopsis of your experience.

14. ”CCO Swag - Pay it Forward” Program
http://www.cafepress.com/CCOSwag
CCO-BRAND SPECIALTY STORE
Here is where CCO wants to partner with
YOU so we can all “Pay it Forward”.
The profit from all CCO Swag purchases will
go into a scholarship fund for worthy students
trying to afford CCO courses in their quest to
enter the profession.
You can purchase at the store now.

15. ICD-10 is here! >> ICD-10 CCO Style
● ICD-10-CM Blitz* - $395 - NOW $197
○ Prepare to pass the Proficiency Assessment
exam with ease!!
○ 16 hour course equivalent
* Textbook sold separately
● ICD-10-CM Full Course **Payment Plan Now Available**
○ 80 hour course equivalent
○ using “Understanding ICD-10-CM” text by Bowie
● ICD-10-CM Practice Exams
○ Free 25 Question Exam
○ Paid 50 Question Exam - $29.95

16. Risk Adjustment presented by
Alicia Scott, CPC, CPC-I,
CCO Education Director
with
Content contribution by Subject Matter Expert:
Holly Cassano, CPC
CRC Credential- Risk Adjustment HCC Coding Course Is Here!
Our HCC Course has 16 jam-packed Modules on
register here: http://go.cco.us/risk-adjustment-hcc-coding-
training-course

17. CCO Helpdesk
helpdesk.cco.us
(You can search the knowledge base,
create a ticket
and check up on existing tickets)

18. Poll - What
region of
the country
are you
from?
Poll

19. ● Chandra: A Day in the Life of an RAHCC Coder
● Alicia: ICD Gastroesophagitis
● Alicia: ICD Pregnancy with Drug Use
● Alicia: ICD Degenerative Lesion
● Laureen: Modifier, Global and Bundle
● Laureen: Modifier 24 Scenario
● Team Discussion: ICD-10 Rollout
JoAnne / Laureen / Alicia / Chandra
Coding Q and A Topics
Alicia Scott
CPC, CPC-I, CRC
Jo-Anne Sheehan
CPC, CPC-I, CPPM
Chandra Stephenson
CPC, CIC, COC, CPB, CPCO, CPMA,
CPC-I, CCS, CANPC, CEMC, CFPC,
CIMC, CGSC, COSC, CRC
Laureen Jandroep
CPC, CPC-I, COC, CMSCS,CHIC, CPPM

20. RAHCC Coding
Question: Please describe a typical day in
the life of an RAHCC coder.
ANSWER

21. Poll
What AAPC coding
credential do you HAVE?

22. ICD Gastroesophagitis
Question: How would you code
gastroesophagitis?
ANSWER

23. ICD Pregnancy with Drug Use
Question: Can we code pregnancy
complicated by drug use if the physician
doesn't document a mental or behavioral
effect?
ANSWER

24. ICD Degenerative Lesion
Question: How would you code a
degenerative lesion of the labrum?
M24.111?
ANSWER

25. Poll
What coding credential
do you WANT?

26. Modifier, Global and Bundle
Question: Can you explain a little
about the Modifier, Global and
Bundle?
ANSWER

27. Modifier 24 Scenario
Question: Provider billed with
modifier 24 with an ICD-9 for trigger
thumb only. Does this justify the 24?
Is this significant enough to warrant
payment of E/M within global?
ANSWER

28. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened,
what is the scoop on ICD-10 ?

29. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
Myths:
You
heard
what ??

30. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
What is different on 1/1/16 - anything?

31. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
Expectations:

32. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
What we are hearing:

33. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
What we know:

34. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
How can it be easier?

35. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
Suggestions for the coder / the workplace:

36. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Now that the initial rollout has happened, what is the
scoop on ICD-10 ?
Going forward:

37. ICD-10 ROLLOUT
TEAM DISCUSSION
Team Discussion:
Your Feedback:
The discussion format is new for us,
what do you think?
Respond in chat:
1 - Love the dynamics of the discussion team
2 - Not my cup of tea… straight Q&A is better

38. Want to Say Something About Us?
Like the Webinar?
http://www.cco.us/testimonials
Problems? Try different browsers

39. Poll
Are you interested in any
of our course subjects you
haven’t yet taken?

40. Need Help Choosing a Course?

41. Medical Terminology & Anatomy Course (MTA) 40 CEUs!
CEU Classes (On Demand) ranging from 1 - 4 CEUs each
ICD-10-CM Blitz Course (ICD-10 CM Proficiency Assessment) 16 CEUs!
ICD-10-CM Full Course 40 CEUs!
Facility Based Coding Course (FBC) 40 CEUs!
Physician Practice Manager (PPM) 6.5 CEUs!
Physician Based Billing Course (PBB) 18.5 CEUs!
Physician Based Medical Auditing (PBMA) 12.5 CEUs!
Looking to Fulfill Your CEU Requirement?
More CEUs from CCO! http://cco.us/products

42. LIKE us on Facebook
http://facebook.com/cco.us
Help Us Get The Word Out

43. www.YouTube.com/MedicalCodingCert

44. If you don’t already receive our
newsletter, send a message to
helpdesk.cco.us
request to join ‘The Insider’s Club’
(Send from the email address you
wish to receive your newsletter)
Join the “CCO Insider’s Club”
Monthly Newsletter
● Timely Industry Announcements
● New Course Announcements
● Remote Seminar Partners
● Congratulations to our Grads!
● Testimonials - what are people saying?
● Current Blog links
Gain Access to Our Best Free Medical Coding
and Reimbursement Resources!
Introducing our New Weekly Newsletter Format
“Heads-Up Tuesdays”
Short and Sweet Links to:

45. Blitz Video
Package
or
2 CEU Webinars
or
1 Hour Session
with Laureen
(or Alicia)
Free Drawing! Your Choice of:
Let’s Pick A Winner!

46. Questions In The Chat
ANSWERS
Your Webinar Chat Team

47. Links Referenced in the Webinar
Forum - http://www.cco.us/forum/
Testimonial - http://www.cco.us/testimonials/
BookStore - http://store.cco.us/
Swag Store - http://www.cafepress.com/CCOSwag
MAUD Webinar Link - http://www.cco.us/medical-coding-auditor
ICD-10 Blitz - http://go.cco.us/icd10-blitz
ICD-10 Full - http://go.cco.us/icd-10-cm-full-course
RA HCC - http://cco.pe/10qGz8g
MCB - http://go.cco.us/medical-coding-billing-course-bundle
Helpdesk - helpdesk.cco.us
Course List - www.cco.us.com
Replay Club - http://go.cco.us/webinar-replay-club
Facebook - http://facebook.com/cco.us
YouTube - www.YouTube.com/MedicalCodingCert
CEU Link - http://go.cco.us/ceu
xxx -

48. Chat Q & A
Webinar- Oct 2015

49. Book for RA Coder
Question: What is the best book for an RA
coder?
Answer: There isn't really an RA coding
book...if they really want a good idea they
should look at the participant’s guide for
Medicare Advantage Plans...

50. HCC Positions
Question: How can I know if an HCC coding
position is legitimate? Is there anything I
should look out for when looking for an HCC
position?
Answer: Do a little research on the company
offering the position. Generally, these
organizations will not ask you for $ and will
allow you to ask a lot of questions up front to
clarify what they are looking for, etc.

51. Importance of CPCs
Question: Please help me as to how to
inform (what to say, what evidence to
quote) to the Deans at a Community
College when I teach a Billing and Coding
course as to how important CPCs are.
They feel Certified Coders is no longer a
needed profession to teach courses for, so
we are only giving our students an overlay
of all the positions in a doctor's office. Help
please.

52. Importance of CPCs - Answer
Answer: What I would do is explain the liability
associated with incorrect coding and the amount of
time the physician already does not have. We are
seeing an increase in the number of providers and
organizations recognizing the importance of coders
and the value they add. I know a local review
manager for a Medicare plan in the Midwest who
advises their providers to have a CPC or other
certified coder review anything before it is submitted
for appeal.

53. ICD-10 Unspecified Codes
Question: Can you touch on unspecified
ICD-10 codes and if medicare, etc will
pay these codes..thanks

54. Abnormal Finding
Question: What is considered an
abnormal finding during a routine
preventative exam?

55. Abnormal Finding - Answer
Answer: According to ICD-10-CM, an
abnormal finding is anything found during
the examination that the provider did not
already know the patient had. Chronic
problems do not count. Generally, it is
something the provider finds that neither the
patient nor the provider knew the patient
had (i.e., heart murmur, uterine fibroids, etc)

56. Tobacco - Abuse vs Dependence
Question: regarding the tobacco use
diagnosis codes....abuse vs dependence.
Z72.0 tobacco use and F17.210, my
understanding that unless the physician
documents dependence or the specific word
"smoker" according to coding clinic then we
code use Z72.0. Even if the patient smokes
2 packs a day unless the physician
documents dependence we can't code it, is
this correct?

57. Tobacco - Abuse vs Dependence
Answer: You are correct, the Z72.0 code should be
used unless the provider indicates the patient is
"dependent." I have seen organizations develop
policies where providers agreed on what constitutes
"dependence". The reason they do this is they say
there are certain things that automatically indicate the
patient is dependent. Well, dependence is defined as
developing a tolerance for a substance or going through
withdrawal when a substance is removed. If a patient
smokes 2 packs per day they typically have an
increased tolerance to nicotine and will go through
withdrawal if we take the nicotine away.

58. Annual Physical
Question: ICD 10 question, if a patient is
in for an annual physical and has chronic
conditions like DM or HTN, would you
use Z00.01?

59. Thanks For Coming! Get Value?
http://www.cco.us/testimonials