Should I start classes as a medical coder while keeping an open mind towards learning new skills beyond the basic entry level? Or should I pursue another entry? What would the next step be?
If you are truly interested in the field as a career, then you should move forward as planned. While the roles are going to change, the foundation of knowledge to be learned will still be required. In one way, you will have an advantage of not having years of experience to change or adapt to. You will be learning in the current state of the industry. You may contact us at www.aaocmp.com and open a chat and we can help consult you. You ask a great question showing that you are well focused.
What I am hoping is that AI will become a tool that is still going to require human oversight, thus a human still needs to perform the job, but like has happened over and over since technology of any kind was made, each advancement allows 1 human to do the work of more than one human in the current status quo system that the new tech is altering.
This is exactly what is occurring right now. AI is reducing workloads and the result is the need for fewer Medical Coders. The Medical Coder of the future will be the oversight and will need to be highly skilled, dynamic, and able to resolve what AI cannot. It is already making the employment market far more competitive. Single skill coders and those that do not strive to excel are going to find the future quite challenging.
@@aaomcpakacompliantcodingsy7483 problem is, this is happening across the board for all kinds of jobs and at some point the number of better paying skilled jobs is going to become so small that the majority of people working those jobs will have to shift to lower paying jobs, if they can find work. I am very concerned about that.
Instead, many stakeholders are deflecting. Certification Organizations downplay this for what should be clear reasons. Employers are not inclined to be transparent since they have incentive not to be.
Thanks for comment. We will add that to the Top 10 list. Maybe make it the Top 15. Being in India doesn't mean one can't earn. We have worked with people in India that do. Unfortunately, that is a real example of the #1 on the Top 10 list "I Can't". Just know that "You Can"1 Best wishes!
@@aaomcpakacompliantcodingsy7483 sir I have one question can AI replace Medical Coder or Medical coding is good choice to start a long carrier for 15 20 years or is there change is coming in USA regarding medical coding? Please answer sir.
Thank you so very much for taking the time to share your perspective and we are glad that we were able to help. We hope that you will reach out to us so we can offer you a Thank You gift. We also help that all your goals are achieved and are here to help if needed.
I've been in the coding industry for 25 years. I'm doing account follow-up right now. The accounts are a hot mess. Resolving them has to do with the barriers put in place by the health insurance companies. It's criminal. AI can't solve what I'm solving. The only resolution AI could provide is a write off. Thats NOT going to help the bottom line. I'm open to what's next to develop but am struggling with how much I can tolerate to learn.
If possible make a video on annual wellness visit, preventive visit, telemedicine visit, annual physical exam for medicare and other payer. With sample chart.
GOOD MORNING🙏🏼 IF PROVIDER ONLY STATES: PT TAKES 3 ANTIHYPERTENSIVES REFILED TODAY- BUT PROVIDER DID NOT ADD THE MEDICATION OR DOSAGE- WOULD THIS BE CONSIDER3D PRESCRIPTION DRUG MANAGEMENT??
If the information from the CMS MACs that is presented in the video is followed, my opinion would be no. The CMS MACs leave a great amount of latitude/flexibility but largely state that dosage and medication must be documented. One should review the MAC statements and proceed accordingly. Hope this helps!
I am new to HCC coding and the question I have is do you code all diagnosis in the chart are just the one's that risk adjust? I have many years of inpatient and outpatient coding. Thanks
Thank you for your comment. It is hard to know if they are truly gaslighting, or just speaking outside their knowledge limits. Gaslighting is intentional (and stakeholders such as certifying bodies and employers would have motivation to to do this) equally disinformational though perhaps not with "intent" is talking about something that one does not fully understand. It is clear that many of those putting videos out have never spoken to an AI Developer, never seen "under the hood" of AI, and do not truly understand it. Perhaps it is for "clicks and likes". May of them refer to ChatGPT as if that is the AI that is being deployed in Medical Coding. 3M, Optum (Change Healthcare), and others are not setting ChatGPT loose on the healthcare field. They have spent a decade or more and countless resources developing Medical Coding AI. Unfortunately, in this era of information overload where everyone is a self pronounced expert and others will believe just about anything, it is easy to be duped if one does not have the initiative to fact check.
You are welcome and thank you for the note. We want all to be successful. Not just a single billionaire exploiting the hard working Professionals in our field.
Hi and thank you for your comment. It should be noted that documentation should not be performed to "coding rules". In other words, complete and accurate documentation is the goal regardless of coding and reimbursement. It is a legal record in case of treatment disputes (appropriateness, etc.), it is used for research, continuity of care, and more. Coding is a downstream task that relies on documentation. In fact, coding should never be performed to "achieve" a desired reimbursement. The documentation is the driver of reimbursement, not the other way around.
I can see medical coders doing insurance denials also...multi tasking . They will still need med coders some to view to ensure documentation is correct. I can see submitting record to payers but rejected cause details not picked up. And if document is good with details you can code up to 70 or more records a day
Thank you again for your comment. You have contributed great insight on several of our videos and it is greatly appreciated. Once again you bring up a great point! AI will "shift" many roles and those that have the "range" of skills will be able to act on the adage "where one door close, another door opens" and you clearly understand this. The underlying message is "be prepared" and you seem to have the right mindset to be prepared and have every advantage as AI evolves. We are cheering for you! Thanks again! We look forward to hearing more form you.
I’m a medical coder working on an AI project right now. So AI scrubbed the charts I check that the codes are correct. The technology this year is correctly capturing most codes. My expected CPH is 8 per hour!! Impossible to do. I’m expecting to be let go 😢since I had til Monday /today to improve. I just logged out that’s when I caught your blog.
We do hope that you realize that you are already ahead of others by recognizing the evolution. There is a link in the description and we are here to assist in preparing. In any case, we appreciate your open and honest comment (a sign of strength) and we are pulling for you. Be well! <3
I totally can relate to your trauma. I am a coder and was catfished into an account follow up role. They said it would be denials. Rejects are 7 CPH and Denials are 5 CPH. The accounts are a hot mess. I am struggling because I don’t want to commit fraud. It is sad.
Please confirm 0.346 HCC111was first used as an example on Harriet but then later changed to value .335 when used in the risk score calculation example for Harriet. Thank you, great presentation
Hi! The weights were used for example. They may have changed from example to example. No intent to create confusion and we apologize if any was created. The Mappings and Weights change year to year so they would be different now than at the time the video was created. Our complete program is always up to date including the recent major changes made by CMS. And, Thank You for your kind words and for watching! You may always visit aaomcp.getlearnworlds.com/ and open a chat with additional questions.
I have sampled many "Intro to Rusk Adjustment" videos and this one I stuck with and listened to more than one to get me prepared for the Risk Adjustment program I will be starting. Your method of teaching is very good! I now understand the concept of risk adjustment, and can follow along in the video with understanding.
Hi Just wanted to know is this Trump logic applicable for status codes also? For example - 1. E11.69( HCC 18 DM w/ complication and Z79.4( HCC 19 Insulin)? 2. Hemodialysis Z99.2(HCC 134) and ESRD( HCC 136)? As Insulin and Hemodialysis both are status codes, do we need to follow TRUMPING in the above scenarios?
Trumping is not based on "codes" it is based on HCC Hierarchies. Meaning, that by the time Trumping is applied, the coding has already been accomplished to determine the appropriate HCC(s) and if 2 or more HCC's exist in a hierarchy, which HCC will count towards the Risk Score. So, to answer your question, coding deals with the "Mappings" (assigning the accurate DX Codes) which then in turn will determine which (if any HCC) applies, and then (again) if 2 or more HCC's in a hierarchy exist, which is the highest weight. The highest weighted HCC in the hierarchy will count towards the Risk Score and others in the hierarchy will not. When you ask "Do we need to follow TRUMPING in the above scenarios?" The answer is this. No coder applies trumping or calculates a Risk Score. So, answer 1 is No, you are not responsible for actually applying the trumping, Answer 2 is, to be a knowledgeable Professional, you should be well versed in what you are doing and why you are doing it, even if you are not necessarily responsible for that particular element. Answer 3 is, in the scenarios presented, the goal is to code according to all guidelines, starting with the Official Guidelines for Coding and Reporting as well as AHA Coding Clinic to arrive at the most complete and accurate code assignment, and thus the most accurate HCC(s). In the case of Medicare Advantage and the CMS HCC Model, CMS filters the data, uses that data to apply the appropriate HCC based on the coding, and then calculates the Risk Score. If you are making bread, you know to put yeast in the bread to make it rise, You are not making the bread rise, but you understand WHY you are putting the yeast in to achieve the result. Hope this helps!
Are "disease interactions" along with their HCC and Weight automatically added when two chronic conditions that interact are present or does the physician have to code the disease interaction? If so, what are those codes?
Past Medical History: s/p kidney txp,CVA 2010, bilateral cataract sx, CABG 2018, erectile dysfunction, nocturia. Pertinent negatives include DM, CHF, and HLD. What are the codes for this? Thanks
This was very helpful as I embark on my new career into coding. I've been in the medical field as a provider for over 20 years. Coding is a whole different world! Thank you!
This is like the only reference I can find--anywhere--that lists the categories (2:50 in your video)! Is there a comprehensive list that starts with Category-->HCC somewhere? Like "Category 3 (diabetes) has HCC18, HCC19 in it"?
The resource that groups by Disease Category is AAOMCP material. However, the "Trumping" lists may be helpful for you. You may download these at aaomcp.getlearnworlds.com/downloads
I knew absolutely nothing about HCC and diagnosis coding nor risk assessment. Now I feel like a have a basic knowledge. A least a "terms and definition" basic knowledge, so when someone starts throwing out acronyms, I won't be completely loss! Thank you! It has the perfect amount of detail. I live the "Cats" and Harriet and Ozzie. Came at the perfect time to recapture my attention before it all started going over head and my eyes glazed over from confusion and stupor of thought. Entertaining and informative...the best kind of class. Well done! Thank you.
The CEU was available at the time of the video. Based on the date of your view, that CEU is no longer available. Please visit www.aaocmp.com and open a chat for assistance with CEUs.
Good presentation. But it seems like that some errors in the presentation. Based on HCCs (19. 96, 11, and 85) from the example, three disease interactions (CHF * DM, CHF * COPD, and CHF * Specified Heart Arrhythmia) SHOULD be counted. But only one is counted. Please correct me if I am wrong.
Thank you for your observation and your correct statement. In the presentation it was mentioned that the scenario was for illustration purposes. The illustration was simplified intentionally so as not to confuse the audience with a complicated scenario where the point being made would risk being lost. This presentation is an “Introduction” and an “Overview” and is not intended to be a formal “class” and the presentation begins with a disclaimer to that effect. Indicating that the specialty of Risk Adjustment cannot be learned in a brief webinar. As such, some points are meant for illustration and general concept understanding for the sake of time. Only a full course provides the time to expand on every element. That said, your observation demonstrates that you are a knowledgeable Professional and have terrific command of the subject matter and you are to be commended for your expertise.
The CEU was available at the time of the video. Based on the date of your view, that CEU is no longer available. Please visit www.aaocmp.com and open a chat for assistance with CEUs.
Hello, please give more guidance when you have time: F10.24 was assigned based on the scenario the coder mentioned. I am investigating this further to understand fully. I read in the AMA's 2019 ICD-10-M Documentation book, p.91 that "codes from this chapter requires documentation by the provider of a relationship between the psychoactive substance and the mental or behavioral disorder." This is also repeated in the Optum 360 Coder's Desk Reference for ICD-10-CM Diagnoses, p. 210. It states, "Alcohol dependence codes should only be assigned based on provider documentation. Codes from this subcategory that describe a mental or behavioral disorder should be used only when the relationship between and alcohol dependence and the documented mental or behavioral disorder has been clearly established in the provider documentation. " I understand the guidance is just emphasizing that there must be MEAT or support for the F10.24 diagnosis and not just a patient with MDD with Recurrent Severe with psychotic features and Alcohol Dependence with a BAL of 202. Thanks for your teachings
