HI, Cindy Johnson. I'm going to go over some highlights
from a few of the chapters from the Coding Handbook.
I'll start with Chapter 2.
One thing that's talked about in Chapter 2 is the importance of indentations
and how you must follow those when finding terms
so, I wanted to use the example of asphyxiation, here,
and traumatic asphyxiation
and how many times that
it's subdivided and how many times the indentation
goes down. This one line right here is a carry-over line
when it says "see foreign body, respiratory tract..."
it has been indented twice when it's a carry over line
otherwise, your indentations here mean something.
It means you're going to the next level for a term. And, it's important
to be able to follow that as it's indented, so you can either use
the straight edge of the page after the page you're working on
or, you can get a white piece of paper
and just use that as a way to follow
the indentations. So, we're under asphyxiation -
traumatic - due to
low oxygen content of ambient air - due to
being trapped in - low oxygen environment
in a car trunk - circumstances undetermined - done with intent to harm by -
another person or self. So, see how many times
that content was indented before you finally got to your
final code. So being able to follow that
using some tool to be able to follow that so you don't get confused.
That's one thing I wanted to show. The other thing is you'll notice all of the black boxes
with the white check marks. That indicates additional characters
are needed, and you'll also see there will be
terms sometimes that have a dash after them like this
hyperthyroidism, "M" fourteen point eight dash
That dash also means additional
characters are needed. In our exercises that's
what you're going to see when I'm telling you there are additional characters needed
because I don't have a way to reproduce the little black box.
Also, I wanted to bring to your attention
an example of "essential" and "non-essential" modifiers.
The term "Asplenia," which means without a spleen,
congenital in this example is a non-essential modifier.
It does not change this code. In the medical record
you might see is as just Asplenia or you may see it as Congenital Asplenia
and either term is going to get you to this code.
But, if you see "postsurgical" this is now
an "essential" modifier therefore the code is different
This is a good example of a "non-essential"
and an "essential" modifier. The next thing
I want to show you is from Chapter 3.
"Relational Terms" this is sometimes confusing
The word "And" should be interpreted
to mean either "and" or
it can mean "or" when it appears in a code title.
So I looked for an example besides the one that's in the textbook
to show you what I'm talking about and I saw L97.411.
So let's go there L97.411
"Non-pressure chronic ulcer of the right heel and midfoot"
This is an example "and"
and it can be read as "or".
So if your medical record says, "Non-pressure chronic ulcer of right heel...
"Non-pressure chronic ulcer of the right heel"
this would be the correct code,
because you would read this as "or." In other words
you don't have to have a chronic ulcer of the right heel and right midfoot
limited to breakdown of skin to be this code. You can read that
"and" as "or." That's one thing I wanted to show you in this chapter.
The other thing were the "EXCLUDES 1" and
"EXCLUDES 2" notes. You may have read that.
And, I'm going to go to M43.
When I use my textbook I write in my
Code Book because I don't know how you keep all of this straight.
I can't remember all this, I need notes. It's important for you to
realize, this codebook is your tool. If you do decide
to move forward and get a coding credential, you can use the Code Book
when you take the CCS Exam. You do not use the Code Book
when you take the RHIT Exam but what the
(RHIT) exam does is it reproduces these codes (numbers) as
though you were looking at a Code Book, so you're not having to
memorize things so much as know where to find them in your Code Book.
Here's an example this "fusion of spine" right here
where it has an "EXCLUDES 1" and an "EXCLUDES 2"
note. "EXCLUDES 1" means
two conditions cannot be reported together, so that the "fusion of the spine"
cannot be reported along with "ankylosing spondylitis."
Those are two different things.
This "EXCLUDES 2" note here, the patient may have
both conditions at the same time. So you could report
"fusion of the spine" and an "arthrodesis status."
This is a good example of "EXCLUDES 1" and EXCLUDES 2" notes.
Until you become very familiar with what they are, I suggest
making notes like this in the columns so you know
what those two terms mean. They are very, very important.
This is an aside, the Coding Clinic which you remember
from one of my first podcasts tells you that that's like our "Bible"
as coders of how we know how to use this codebook and
so we're all using it the same way. The Coding Clinics have
intimated that there is going to be a lot of changes with "EXCLUDES 2"
coming down the road. They're finding that they've
used that a bit more than they should've or they
should've used that when they used "EXCLUDES 1" so you may hear more
about that if you decide to stay in the coding field.
That's what I wanted to say for Chapters 2 and 3,
and we'll go forward from there.