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Please post initial responses and peer responses to the following discussion questions listed below:Shawn is developing a presentation on Guidelines for first year coding students. What should Shawn include to help the students understand the importance of the Guidelines?Different sections of the CPT manual use different methods of organizing the information they contain. Some have major subdivisions based on anatomical site; others base their divisions on procedures. Discuss the reasons why different methods make sense, given the nature of the information represented in the different sections of the CPT. What are two examples to illustrate your thinking?
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Module 5: Q2
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Katie Corcoran posted Sep 20, 2023 7:07 PM
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2. Different sections of the CPT manual use different methods
of organizing the information they contain. Some have
significant subdivisions based on anatomical sites; others found
their divisions on procedures. Discuss why different ways make
sense, given the nature of the information represented in the
various sections of the CPT. What are two examples to
illustrate your thinking?
Current Procedural Terminology (CPT), also known as CPT-4, is
a coding manual that the AMA created to be able to convert
widely accepted descriptions of medical terms. These can range
from medical, surgical, and diagnostic services. These are then
broken into five-digit codes that the healthcare providers can
use. CPT codes are used because they are a quick and efficient
way for healthcare providers to communicate with third-party
payers such as Medicare, Medicaid, and commercial insurance.
The majority of CPT codes are referred to as Category I codes.
These are codes that the AMA has approved.
Category I CPT codes are unlisted codes widely used to
describe services and procedures that the FDA approves.
Category II CPT codes are the codes that are available for
procedures that are being coded for while using the CPT
guideline. These codes are reported as a part of the Quality
Payment Program.
Category III CPT codes are emerging technology and are
temporary codes. These codes describe the services and
procedures the FDA has not approved.
CPT codes are necessary because they help track the health
and performance data that can then be used to show the
efficiency of the codes.
DB 5 Question 1
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Erin Pickles posted Sep 20, 2023 8:14 PM
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1. Shawn is developing a presentation on Guidelines for firstyear coding students. What should Shawn include to help the
students understand the importance of the Guidelines?
Shawn should keep in mind that coding can be a challenging
task to learn while creating a presentation on recommendations
for first-year coding students. Shawn should strive to teach
students the fundamentals of coding and provide an easy-tounderstand overview of all of the regulations. Shawn needs to
explain what coding is in his presentation without delay. He has
the competence to explain the significance of coding, its
applications, and how it influences healthcare. Given how
important the ICD-10-CM is to coding, if I were Shawn, I would
additionally include a few slides to explain their importance. I
would dissect the ICD-10-CM during this part of the discussion
by describing its various components and how to utilize them.
The ICD-10-CM contains a variety of elements that facilitate
coding, but you must first comprehend them, thus Shawn
should discuss them as well. Students participating in Shawn’s
discussion could possibly learn better by hands-on participation
and/or observation. Due to this, a substantial portion of the
discussion should consist of examples that Shawn guides the
students through with detailed explanations. In addition to
describing to the students how he identified the appropriate
code to illustrate it, he may additionally include criteria. He can
also give some instances to illustrate difficult-to-code scenarios
and the most effective ways to come up with solutions to these
issues. Because it has an impact on so many facets of the
patient’s experience, follow-up visits, and the reimbursement
system, accuracy in medical coding is crucial. The students need
to understand why it is so important for their coding to be
accurate, thus Shawn should include information regarding
crucial factors in his presentation. Last but not least, Shawn
needs to inquire about any coding-related queries the students
may have. Students can share their questions and experiences
with one another and learn through each other’s additional
inquiries.
Module 5 Question 1
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Cami Williams posted Sep 19, 2023 12:09 PM
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1. Shawn is developing a presentation on Guidelines for first
year coding students. What should Shawn include to help
the students understand the importance of the
Guidelines?
o Shawn should talk about the difference between an
algorithm and a program, and why it’s important for
them to know these differences. He can then go on
to list some of the guidelines that are included in the
IEEE’s standard for designing programs, which
defines what counts as a “complete program.” This
list includes things like handling multiple inputs,
checking for errors, and performing other tasks that
programmers need to know how to do when they
write their own programs. In order to effectively
teach students how to follow the Guidelines, Shawn
should include a list of examples of how they are
applied in real life. This will help students
understand what the Guidelines are intended to
accomplish, and why they are important. Within
Shawn’s presentation, he could show a short video
or two further explaining the Guidelines and how
they can be applied. The videos should be clear and
concise, as well as readily available to the students
such as a video on youtube that the students can
view again later at their leisure. Another helpful tool
would be to have a handout of the Guidelines hung
in his office and around the room for students to
view. By being able to view the Guidelines
frequently, the students can become more familiar
with them and become confident in their
knowledge. It can be an easy way to create
productive conversation and application of the
Guidelines.
2. Module 5 Discussion Question 1
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Ravyn Laird posted Sep 20, 2023 4:03 PM
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1. Shawn is developing a presentation on Guidelines for first
year coding students. What should Shawn include to help
the students understand the importance of the Guidelines?
Shawn should explain how coding and patient safety are
related. Students need to understand that coding plays a
crucial role in quality care and zero harm. Providers rely on
information that is coded accurate to make informed
decisions on patient care. It is also important to understand
that coded information stays on the patient’s record
permanently.
Another important aspect of coding that Shawn should
emphasize is the role it plays in reimbursement. Complete
and accurate documentation of every patient encounter
ensures the healthcare organization receives the appropriate
compensation. If coding errors arise the claim will
automatically be denied. It is essential that the students
understand that increased claim denial rates equal decreased
revenue for the healthcare organizations.
When it comes to preparing the presentation Shawn should
use easy to read fonts and no bright colors. Bullet points will
also aid the students in retaining the information making it
clear and concise. His first slide should define what
healthcare coding means and its role. Next Shawn should get
into what ICD-10-CM is and how it influences healthcare.
Shawn could also use videos to help aid his students’
understanding on Guidelines. At the end of the presentation
time should be dedicated for a Q&A that will allow students
to ask questions and learn from each other. It is essential
that the environment remains educational and professional
to ensure optimal effectiveness.
References.
ICD-10-CM official guidelines for coding and reporting. (n.d.a). https://www.cms.gov/files/document/fy-2022-icd-10cm-coding-guidelines-updated-02012022.pdf
Elsevier. (2021). Buck’s Step-By-Step Medical Coding, 2022
Edition. Saunders. pp. 73, 205-7, 217.
Module 5 Question 2
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Jill Heflin posted Sep 20, 2023 6:26 PM
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1. Different sections of the CPT manual use different
methods of organizing the information they contain. Some
have major subdivisions based on anatomical site; others
base their divisions on procedures. Discuss the reasons
why different methods make sense, given the nature of
the information represented in the different sections of
the CPT. What are two examples to illustrate your
thinking?
Current Procedural Terminology (CPT) is a manual of
standardized set of codes and terms that was developed by the
American Medical Association (AMA). This manual was
developed with the intention to describe tests, surgeries,
evaluations and any other medical procedures to streamline
reporting, as well as, improving accuracy and efficiency. Each
CPT code is five characters and may be numeric or
alphanumeric. The CPT manual is divided into three categories:
Category I, II, and III.
Each of these CPT categories have different methods of
organizing the information that they each contain. For example,
Category I is divided into six large sections based on which field
of health care they directly relate to: Evaluation and
Management, Anesthesiology, Surgery, Radiology, Pathology
and laboratory, Medicine. Each section is further divided into
subsections with anatomic, procedural, condition, or descriptor
subheadings. The sections are grouped in numerical order,
except for the Evaluation and Management section. The
Evaluation and Management section appears at the beginning
of the listed procedures and are often the most reported codes
in the CPT manual. The Radiology CPT codes are divided into 4
groups by modality: Diagnostic, Ultrasound, Radiation
Oncology, and Nuclear Medicine. The CPT codes are an
integral part of the medical billing process. With the division of
each section, this allows for the coding of simple versus more
complex procedures.
Module 5, Question 2
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Carson Lemon posted Sep 19, 2023 12:42 PM
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The Current Procedural Terminology manual, or CPT manual,
offers healthcare professionals a guide in coding every medical,
surgical, and diagnostic service. It is used to report medical
procedures and services for processing claims, conducting
research, evaluating healthcare utilization, and developing
medical guidelines for healthcare documentation. This coding
manual was developed by the American Medical Association or
AMA, and it uses 5-digit codes to describe all medical
procedures and services. The CPT manual uses different
methods of organizing and classifying information based on
different types of information.
There are three main categories the CPT manual uses to
identify the different types of codes. Category I CPT codes
describe distinct medical procedures or services and are
updated annually. In addition, there are 6 main sections within
the Category I codes; these include Evaluation and
Management, Anesthesia, Surgery, Radiology Procedures,
Pathology and Laboratory Procedures, and Medicine Services
and Procedures. This first category covers all widely known and
used medical services and procedures.
Category II CPT codes, or supplemental tracking codes, are
used by healthcare workers to track specific information about
their patients. For example, providers can see whether a patient
uses tobacco or is on hormone replacement therapy. These
codes are updated three times a year and help provide better
quality of care for every patient.
Lastly, Category III CPT codes are temporary codes that
represent new technologies, services, and procedures. These
allow for assessment and evaluation of these new services, to
see if they might eventually move up to be a Category I code.
These codes are released every 6 months, and they can only
remain in the third category for up to 5 years.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/
Module 5 Discussion Question 2
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Emily Landewee posted Sep 19, 2023 7:24 PM
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2. Different sections of the CPT manual use different methods
of organizing the information they contain. Some have major
subdivisions based on anatomical site; others base their
divisions on procedures. Discuss the reasons why different
methods make sense, given the nature of the information
represented in the different sections of the CPT. What are two
examples to illustrate your thinking?
The Current Procedural Terminology (CPT) manual describes
the coding system developed by the American Medical
Association. This system is used by healthcare organizations to
take the descriptions of medical, surgical, and diagnostic
services from healthcare providers and turn them into five-digit
numerical codes. These codes allow efficiency in the
communication between health care providers and third-party
payers.
Ensuring that the reported code is correct is extremely
important. If an incorrect code is reported, the provider can be
reimbursed incorrectly, and risk being penalized by the
government for submitting an inappropriate claim. The CPT
manual is updated annually to stay up with the current coding
processes and provide the most current information available.
This is why it is important for the CPT manual to be broken into
different sections, because all of the topics need to be
explained in a way that makes it easy for the reader to
comprehend. Within these sections, different methods are used
to explain the information. The CPT manual is composed of six
sections. These include Evaluation/Management, Anesthesia,
Surgery, Radiology, Pathology/Laboratory, and Medicine. These
sections are then broken down into subsections, subheadings,
categories, and subcategories. Using these tools allows the
person using the manual to get around it faster and easier.
One example to illustrate the methods of the CPT manual is the
surgery section. This section is broken down into subsections
including Integumentary, Musculoskeletal, Respiratory,
Cardiovascular, and many more. We can see that these
subsections are all systems of the body. This can further be
broken down into a subheading like arteries and veins, a
category like embolectomy/thrombectomy, and a subcategory
such as arterial, with or without catheter. So, this section was
broken down into systems that were further broken down into
anatomy and procedure. This process allows the user of the
manual to use it more efficiently since it is broken down using
precise organization. My second example is the radiology
section. This section is broken down into subsections like
diagnostic ultrasound, bone/joint studies, radiation oncology,
and other imaging fields. This makes sense because unlike
surgery being broken down into subsections by the body
system, radiology is broken down into imaging modality
subsections because these can then be broken down into
subheadings and categories related to each modality. This
organization allows the reader of the manual to find what they
are looking for in an efficient manner.
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