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Last exam for Module I - student

Posted: Aug 20, 2012

So excited! Submitted the last exam for Module I today - only 3 more modules to go. I love, love, love school and am learning so much. I hear CPT codes are clear as but, I will see how it goes before coming to that conclusion.

oops - clear as mud - student

[ In Reply To ..]
meant to say clear as mud above (grin)

Module I of what? - x

[ In Reply To ..]
xx

coding course I'm taking, nm - student

[ In Reply To ..]
nm

CPT code clarity depends on you - Coder

[ In Reply To ..]
Seriously, CPT codes are not as horrible as they are made out to be. At first, just about anything is confusing. Same with CPT.

One thing that is not immediately clear from textbooks -- you know they don't like to say anything BAD -- is that the index in CPT is not very good. That's ok, because you are NOT expected to USE IT like you use the index in ICD-9.

In ICD-9, you must use the alphabetic index to find your code, then you check it in the tabular list. If you are properly trained in ICD-9, you will do this without thinking. Many students then go right into CPT thinking they still need to do that.

With CPT, however, you could still find codes if you had no index at all. You can tear out all those pages and never miss them. That is because CPT codes are organized by specialty. Within each specialty, they are organized further by what the procedure is or does.

Once you have an idea of that layout, you can just flip around to find what you want.

If you try to use the index, though, you can have problems if you do something like look up colotomy and stop too soon at colectomy. (Spelling counts!) Or, you can be coding a knee joint injection, look up injection, and blindly code an injection for a flu vaccine, not realizing that a joint injection is somewhere else entirely. And is an aspiration. So, you have to know how something will be listed in the index before you can find it successfully. On the other hand, you might have better luck if you also just rummaged through the pages of codes.

One classic idea that coders seem to miss is that there may be a bunch of miscellaneous codes at the end of the section or group. Don't select a code until you look there. This is especially true in the anesthesia section.

Another issue in CPT is all that text. For some reason, students and lots of coders think all that colored text is just idle blathering. You know, kind of like the preface and introduction to a book. Nobody reads those, and few coders read all that colored text.

You should, though, because that is where CPT tells you its rules and assumptions. That's where it tells you how to use the codes. Textbooks often explain that stuff, but students think the textbook is pulling it out of a hat. They aren't, though. It's coming straight out of the code book.

Read that material, outline it, and apply it. It will make things much more clear.

Another classic stumbling point is the layout of the codes. Be sure you find and learn what those indentations and the ; (semicolon) mean. I've seen coders with 10 years of experience who thought it was just odd punctuation, never realizing that it would have made code selection much more clear. (Some coders never even NOTICE it!)

In ICD-9, you might not have needed all those symbols. In CPT, you do. They impart valuable information.

Be careful about trying to go too fast. Avoid falling prey to the belief that if you don't take a shortcut with the index instead of looking in the pages, you won't go fast enough to pass a certification exam. If you find your codes by looking through the pages now, you'll be fast enough by test time, and you'll be more accurate. You'll also be immune to freaky questions on tests that were written because they know you can't find it in the index.

The only real issue is Evaluation and Management Codes. That is because the CPT book has one way to level the service. CMS didn't think that was objective enough, so they cooked up more rules. Two years later, they cooked up another set of rules. Many coders are unable to sort these out. Textbooks begin right away by confusing things with the CMS rules. Avoid getting embroiled in that mess until you are comfortable with just what is in the CPT book itself.

Be sure that you are using the CPT definition of terms, too. New and established patients, consultations and referral for care, observation care, etc. They are not necessarily what you think they are. You have to learn those definitions cold and then use them. That is the only way you can select the right group of codes.

Most MTs do well in CPT because they know what the procedures are. They understand that an office or hospital visit results in an office note, a consult note, or an H&P or discharge summary, and they know what the parts of those are. They also know what happens in procedures, especially if they transcribed operative or procedure notes.

So, in many respects, the clarity of CPT codes depends on you. It depends on how well you read, on what you read, on how careful you are, on your attention to detail, and on your willingness to avoid rushing.

Even with that, they may confuse you at first. The more you work with them, the easier they become. Working with them and sorting them out is how you become able to use them. Figure them out. Learn the rules. Make them yours. When you do, they'll start looking more clear.

Oh, and read the codes literally. They say what they mean to say. Every so often a coder kind of dreamily asks "Oh, how do we know what that means? Why, it could mean this, or it could mean that, or . . . we just don't KNOW! "

No, this is not Jane Austen or Tolkien. There is no interpretive meaning hidden in there. We know exactly what it means. It means what it says. :) It really isn't all that complicated. You just have to read it for what it is. Some people have more trouble doing that than others. We let them be inpatient coders.

(No, not really. Inpatient coders have to read literally, too, and they need to be able to use CPT.)

Just be aware that the language in the codes is precise and every word has meaning. If you read them correctly, they are quite clear. You might have to struggle with them for a few days, but you will get there.

Oh, some code groups are notoriously difficult. Radiation oncology isn't particularly easy. Interventional radiology is actually kind of difficult, so don't get to those and freak out thinking you are a dud. It's the codes, not you. There are special courses to teach interventional radiology and cardiology, along with hideously expensive -- albeit excellent -- books. (Look up the Z-Health website and you'll see.)

Work hard and you'll do fine! In 4 months, you won't know why you thought it was so awful!

When I wrote that, I did put paragraphs in. - Sorry NM

[ In Reply To ..]
nm

thanks ;) - student

[ In Reply To ..]
Thank you so much for taking the time to answer my question in such a way that I am put at ease and realize that it's not impossible, but it will be different and will be a learning process (like everything else, huh?). Have a good one.

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