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Learn from my mistake about picking a good coding program - sm

Posted: Jan 20, 2012

I am in my last semester of an HIT program at my local community college. This program is accredited through CAHIIM. I actually found this program on the AHIMA website as an approved AHIMA coding program and was so excited that it was in my hometown. Well, almost two years later and $4000 in student debt, I still have no idea how to code. Sure, I'm great at Math 101 and English 101 and my anatomy is amazing, but I have no idea how to code. One class that I have this semester is coding authentic medical records, and I have no idea what I'm doing. I get a few right here and there, but for the most part I have failed miserably. Why? Because this program is taught all on-line, my teachers never answer my questions, I have no direction, I've pretty much taught myself everything, and no one actually teaches me HOW TO CODE! I even attempted the CCA, which is the "easiest" exam, but I failed. I don't even know if I'm going to sit for the RHIT when I'm done. Needless to say, I wish I would've gone with Andrews from the start. I could be certified and coding by now. So here I am, still an MT, still broke, still credential-less and now 4k more in debt. I have no idea what to do now, but I want to warn others to really, really, really research and investigate before going to a 2-year school.

Thank you! I will add.... - Reader99

[ In Reply To ..]
Thank you so much for taking the time to post about your experience. It truly is a service to others.

I will add a couple of things that I have learned just recently about "higher education:"

* Be careful while attending community colleges, etc. Talk with graduates of that particular class or program.

My friend forked over the dough to attend real estate school at our local community college. He chose it because it was the least expensive option available. He graduated/passed the class, but when he sat for the state certification exam (as a grad of real estate school myself, I can tell you [as can anyone who has done so] that the SOLE POINT and FOCUS of real estate class is to PASS THE STATE EXAM to get your license!), there was an entire section of questions that he couldn't answer because the material had NOT been covered in class! So he DID NOT PASS the test. I also should add that this is a very high-IQ guy, so it wasn't him.

* Be sure to ask questions and ask for class schedules, etc. Recently I learned this the hard way when I enrolled for online classes (very technical IT stuff), only to find out after the fact that the school had an "open enrollment" policy. This MEANS that they will accept students into the program at ANY time, even at the end! Then the classes loop back around. My classes began in the summer, but I learned afterward that in fact it was the MIDDLE/INTERMEDIATE portion of the coursework! After that followed the most difficult part (the conclusion), and then after that classes would finish out with the INTRODUCTORY classes!! Crazy, isn't it?!

At this point, after talking with numerous adult students like myself and having gone through it, it is my opinion that education these days is ALL ABOUT MONEY, namely THEM TAKING YOURS. They aren't really interested in whether or not you actually KNOW anything or can DO anything once you graduate. (YES, that is a generalization and I'm sure there MUST be exceptions to the rule out there, but I have neither encountered nor heard of them!)

OP, I do hope that your situation can be resolved in some acceptable manner. I wish you the best!

Call Linda Andrews and see if she has any ideas - nm

[ In Reply To ..]
nm

She would love to talk to you and there is no charge - for it

[ In Reply To ..]
I bet she will tell you to ask Redpen for help.

Yes, talk to Linda! You need to be rescued! - Code 911

[ In Reply To ..]
It is very difficult to teach yourself to code. Those who try to do so miss some important points early on. Those set the tone for everything after that. It is like trying to speak a foreign language with only a dictionary--you have words but cannot put them together.

Do not let this discourage you. You have learned a lot. You will probably do fine on the RHIT, too, because there is not that much coding on it. Whether you can code or not, and whether you pass the RHIT or not, you can proceed to a 4-year program. There is even less coding on the RHIA, which will give you a very marketable degree and credential. The RHIT is marketable, too. Get a job in HIM and give yourself time to review and catch up.

What about coding do you feel you don't understand? What did you miss early on? I know that it may seem random. Where did they get those answers? Why do I need that code here but not in that question yesterday?

Can you FIND codes? Any code? Or is that where the problem began?

Are you ok with an outpatient record but clueless with an inpatient? Or are you clueless with both? If your course taught both together,you might not be able to see the difference.

Did the problem start the first day or with V or E codes? Sequencing? Figuring out what to code?

Those are some typical problem areas. You might have trouble in more than one.

I agree that you should talk to Linda. When you do, ask her if she thinks Redpen might be able to coach you.

My course taught both inpatient and outpatient - sm

[ In Reply To ..]
But inpatient coding is where I have the most trouble. HCPCS codes were pretty much skimmed over, so I am really confused about those. Inpatient surgery reports are the hardest. I was never really taught how to code a report. I was just given a diagnosis (for example, cyst of thyroid) and told to code it, so I did. I was give a procedure - total thyroidectomy and told to code it, so I did. But when it comes to actually coding a report, no teacher has taught me how to do this. I get lost when I read the report, even though I've been a transcriptionist for 12 years! Coding is so much more complex than just finding a code.

You missed a step - I think

[ In Reply To ..]
OK. Surgeries are a back and forth process. At least at first. Once you become familiar with a group of them, you know what to look for.

I hope you are not using a generic code book. That would be half the problem. You should have an Ingenix.

Look the procedure over and decide what it is in general. Look that up in the index. Look at those codes. What do the choices include? Plain, with something, with something else . . . write this down on paper so your brain has to engage with it.

Keep the rules in the guidelines in front of you. Make a copy of them. Work on becoming able to recite them from memory. Does anything there apply?

Look at the instructions in the code book. They are above, maybe way above, and around the codes. Anything apply?

Look at the procedure report more closely. Going by the code options, did they do any of them? Write down the parts of what they did. Outline it.

Compare what they did with the code choices. You want to find a match. You may be unable to do this in one pass. It may take several cycles through this process. You might have to put it aside overnight so your mind can do its thing while you sleep. When you return to it, it will look more clear. You will find that your ability to sort this out improves overall when you do this.

If there are any procedures left over, are they things that should be coded separately? In CPT, the procedures tend to be package deals. If you the go to ICD-9, you may be frustrated that you do not see that. You may need to code things in addition. Check the guidelines and other information to see if it says you should or not.

Go back and forth until you sort this out. Then and only then check your answer.

In coding you will never learn from the answer key. You cannot look at the examples in the book or key and think you can remember or learn that for later. Instead, you need to be learning to apply the example as you code other things.

There may be pressure in your class to work very fast. This is both unnecessary and counterproductive. You cannot learn to be effective and accurate if you are rushing. You have to be able to DO the work first. If you take time to work this out without worrying about speed, you will be able to develop speed after accuracy.

There is no guarantee that the online answers are correct. There are errors in answer keys in books. Use good judgement. If you do not get the right answer, retrace your steps and see where or why you went wrong. If you cannot get to the book answer it might be wrong.

Sometimes answers include optional coding making you think it has to be there, but omits it in other answers. HCPCS codes are not always used. It depends on what is being coded. There is limited coverage of this because it is easy coding. It is mostly stuff, not things we do. The codes for things we do are only used in certain situations. Those are not what we are coding in school, for the most part.

As an MT, you will be better able to code op reports. You will not be able to do this at the hear-and-recognize level of MT. You will have to sort it out more. You will need to learn what happens in procedures and how they are done. You may need to google them to find out. That helps you to understand actual reports.

Do not assume that the real records you use are actually real. They are often doctored up by an educator. This may omit something important, add something that does not fit, do something surgically impossible, or confuse things, or the person who coded it for the key might have been wrong or coded it for a different purpose than you. Or the person who put the answers on the test might have clicked the wrong one or a past instructor might have changed a correct answer to an incorrect one, or even changed the choices making it impossible.

Try the above on a few cases and let us know how you do.

Did you have completely different courses for in and outpatient, or was it all together? What textbook did you use? And what book are these cases in now? Just the author's last name is enough.

Thanks so much for your reply - sm

[ In Reply To ..]
I am going to use this advice and apply it to my homework assignments this week. But you're right, you cannot rush this, and I am being rushed. I have six days to code 50 reports that are both inpatient and outpatient. This may seem like a long time, but when you don't really know what you're doing, it's frustrating! I feel like I cannot take my time and really understand what I am doing. Not to mention the fact that my instructor rarely answers my questions. They way it is taught is ICD-9 and CPT are taught as two different classes. It's not really inpatient versus outpatient. The books we use are 2011 CPT by AMA and ICD-9 Ingenix. The two books we use mainly are 3-2-1 Code It by Michelle Green. The records we code from are just records scanned on a disk. You've been more help to me than my actual instructor has in almost two years!

Hmm - sm

[ In Reply To ..]
Ok. It is homemade. With only one textbook mixing it up, you cannot sort them out. You also have not had any way to learn by comparison. You have had no exposure to a reference level textbook like Faye Brown or one from AHIMA.

The reason you failed the CCA is that you did not have enough coverage of the material. It was not your fault. If anyone is passing it with that, they may know coding already or be some kind of genius. Or at least had some kind of outside help.

Let's break this down. This looks worse than it is because you are seeing the whole rather than doable bites.

50 records in 6 days is 8 per day with 2 left over. It is 10 per day for 5 days, giving you room for emergencies. That is only 2 hours per day for 8 records at 15 minutes each.

For one week's cases, get 5 or 6 sheets of paper. You need 10, or 8, slots on each. One per case. If you can, print the cases. Distribute them into the slots. Attach those cases to the sheet. You now have a packet for each day. You can take it with you if you go somewhere to begin reading and marking.

You now have LESS apparent work to do. Give yourself 15 minutes per case. It will not take that long. Might only take 10 after a while. On your sheet, write the start and stop times so you can see how long it takes.

Is it a total of 50 or is it 50 every week?

On day 1, look at the cases. Sort them into in and outpatient. Do all of one type together. The thinking is different. It is too hard to change hats.

Thanks for your help! And it's 50 records every week. - nm

[ In Reply To ..]
nm

OK, you can do that - sm

[ In Reply To ..]
You can do it if you break it down into doable portions. It will work if you schedule 8 or 10 each day. It will not work if you just attempt to get as far as you can each day.

I recommend 10 x 5 days so that you have day 6 for overflow, if needed. I also recommend that you set a kitchen timer so you can get some perspective on time. It is to help you see your gradual improvement. When you find you have extra time, take a case from the last day's set rather than starting on the next day.

Seriously, ask Linda to put you in touch with Redpen. I think she can help. She has a great sense of humor, and I know she never uses her minutes, so she will probably be willing to call you.

Andrews has - Coaches

[ In Reply To ..]
too? Are they different than instructors?

Slightly different - sm

[ In Reply To ..]
An instructor is a person who assigns work, might explain things, but often does this on a uniform basis, i.e., they tell everyone the same thing, so that everyone has the same chance at passing. This instructor is a person who then evaluates your work (your achievement) to assign a grade. An instructor, so to speak, can fail you. Instructors look more to be fair across the board in order to rank students by achievement. If you fail, an instructor thinks it's just the way education is and that it is a good thing you are out of the field.

A coach is more someone who gives you what you need to learn, often based on personal evaluation and assessment of where you are in your development. It is someone who accompanies you on the learning path, keeping an eye out for missteps. It is often someone who provides tailor-made explanations just for you. While they assess your progress and achievement, they do so in a way that builds you up. Flunking you out is not on their agenda. A coach sees a lack of progress and thinks "Hmm, what can I do to help this person achieve??" A coach gives you motivation and reason to do better, to achieve higher levels. A coach cheers you on.

I think Andrews has always had coaches, rather than punitive, failure-mongering instructors, so I'm glad to hear they are using the term coach.

Do you mean - Andrews

[ In Reply To ..]
Has instructors plus coaches? Who is Redpen? Is Redpen a coach or an instructor there? I never heard they had both!

Redpen is a consultant/advisor/former instructor at Andrews - sm

[ In Reply To ..]
From what I understand, Redpen helped design the Andrews coding course originally and taught there for years. She isn't instructing now as far as I know, but I think she's probably still advising and consulting. Linda mentioned that they talk often and are good friends.

Yes, - I remember, but

[ In Reply To ..]
the question asked was about the post that said for the student to ask Linda if Redpen could coach her. So, the question is, is Redpen going to coach students that attend Andrews?

I think you may have misunderstood what the OP said - sm

[ In Reply To ..]
The only way to know that would be to ask someone at the school, but that's not the way I read it. I read it as suggesting that the OP needs some help and maybe Redpen could be reached through Linda Andrews, because they know each other, and see if Redpen would be willing to coach her. I don't think it had anything to do with the school. I think the OP got the help she needed on here though. It looked like it to me.

I see, thanks for - Clarifying nm

[ In Reply To ..]
nm

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