Contents - Independent Medical Coding, Second Edition
Introduction
Read It and Weave
What Is Coding?
The History of Coding
Current Code Sources
Annual Coding Updates, Revisions, and Deletions
The Prospective Payment System (PPS)
Diagnosis Related Groups (DRGs)
The Future of DRGs
Accurate Medical Coding ? Purpose and Results in Health
Care Today
How Codes Are Applied
The Purpose and Results of Coding
Coder Shortages
Coding Compliance
Coding Compliance Tools
Coding Guidelines
Are You Ready to Go Solo?
Being Prepared
The Entrepreneurial Personality
Experience and Training
What to Expect
The Rewards of Self-Employment
The Pros and Cons of Independent Contracting
Medical Coding Education and Experience
Coder Education ? Not an Overnight Experience
Coder Boot Camps
Home Study Resources
Job Description ? Coding Specialist
Specific Responsibilities
Other Potential Duties/Responsibilities
Technical Skills Required
Decision-Making and Research Skills
Interpersonal and Organization Skills
Organizations and Websites Offering Education/Training
The Coding Toolbox
Credentials Available
An Independent's Success Story: Michelle Matalone

Continuing Your Professional Education
Knowledge is Power
Workshops and Seminars
Coding Roundtables
Keeping Up with Trends and Technology
Keeping Current on Coding Updates
The Coding Toolbox

Becoming Credentialed
Other Sources of Education/Training
What Certification Can Do for You
Guidelines for Using Credentials
AHIMA Advocacy Resolution
Exam Preparation ? Tips for Organizing Materials and
Managing Exam Time
Study Resources
Examination Time
More Tips for CCA Exam Preparation
CCS-P Exam Tips
CCS and CPC Exam Tips
Nurses as Coding Specialists
From Nurse to Successful Coder: Debbie Elliot

Medical Transcriptionists (MTs) as Coding Specialists
Medical Transcriptionists as Coders
A Successful Independent/Coding/Billing/Recovery Specialist:
Mary L. Smith

Salary Projections Based on Survey Data
Various Positions in the Coding Field

Networking
Internet Resources ? "Net"-Working

HIPAA ? Health Insurance Portability and Accountability Act
Business Associates

Types of Coding Systems
Interpreting Coding with ICD-9-CM
The Emergence of ICD-10-CM
Coder Transition to ICD-10
Coder Productivity ? ICD-10
Why Switch to ICD-10
Training for ICD-10
HCPCS (Healthcare Current Procedural Coding System)
Level I ? CPT
Level II ? HCPCS/National Codes and Modifiers
What are HCPCS Modifiers?
Introducing APCS
E/M Codes (Evaluation and Management Codes)
E/M Code History
Introduction to DRGs ? Diagnosis Related Groups
Where Did the DRG Originate?
Basic Characteristics of the DRG Classification System
The DRG Assignment Process
The Typical Decision Process Used to Assign a DRG to a Case 103
Assuring Proper DRG Assignment
How Hospitals Are Paid Via the DRG System
Case Mix
Case Mix Index (CMI)
Medicare Case Mix is Rising
DRG Optimization/Maintaining Compliance
Chargemaster
The Importance of Documentation
Coding Queries
Physician Coder Query Form

Establishing Your Independent Coding Business
New Independent Freedoms
Rewards of Self-Employment
Staying Focused
Consulting ? The Pros and Cons
What Is a Coding Consultant?
Being Ethical
Coding Compliance
Coding Compliance Tools
Fraud and Abuse
Positioning Yourself in the Current Health Care Environment
How to Compete Successfully
Maintaining Your Competitive Edge
Making Healthy Choices
Clients and Services
Coding in Managed Care/Physician Practices
Coding for Outpatient/Ambulatory Care Clinics
Types of Services to Offer
Consulting Services to Optimize DRGs
Coding Auditing Services
Medical Record Abstracting for Severity of Illness
Outpatient Coding
Outpatient Surgery Coding
Emergency Room, Laboratory/X-Ray Coding
How Coding and Billing Are Linked in the Outpatient Setting
Benefits/Revenue Recovery
The Recovery Specialist
Fees for the Recovery Specialist
Learning Outpatient Coding and Billing
Computer Setup for Outpatient Coding
Reference Materials for Outpatient Coding
The Work Site ? Home-based Coding
Remote Coding ? An Idea Whose Time Has Come
Offshore Outsourcing
The Electronic Medical Record (EMR)
Medical Facility Benefits of Home-based Coding
The Coder Educator
International Coding Opportunities
United Kingdom
Clinical Coders Society of Australia

Alternative Careers for the Health Care Coding Specialist
Cancer Registry7
Functions of a Cancer Registry
Coding Cancer Cases
The Future for Cancer Registrars
Education and Training for Cancer Registry Work
Becoming Certified as a Tumor/Cancer Registrar
A Successful Cancer Registrar ? Valerie McRae
Trauma Registries
History
Basic Training
Achieving Certification
Radiology Coding Certification

Setting Up Business Operations
Planning and Implementing
The Office Environment
Being the Boss Means Flexible Hours
Equipment and Software Needs
Computer Assisted Coding
Encoder Software
How the Encoder "Thinks"
Encoder Pros and Cons
The Alpha II Coding System
What Does Alpha II Do?
Medical Coding Software
Forms
Reference Books and Resource Guides
Building a Web Page
Your Home Page
Marketing and Promoting Your Website
Never Underestimate the Value of Links
Maintaining Your Website
Licensing and Regulations
Professional Liability Insurance

Establishing Fees for Services
Market Research
Rate Variables
Productivity Standards

Marketing You and Your Business
Collecting the Facts
Evaluating Your Background and Experience
Evaluating Your Market and Competition
What Is Needed
Fliers
Clients
The Power Resume
The Power Letter
Follow Up with Potential Clients
Keep Track of Your Contacts
Your Client Relationships
The Interview
What to Bring with You to the Interview
The Winning Image
What Not to Do
Closing the Interview
Networking and Advertising
"Net"-Working
Professional Image and Attitude ? Inspiring Confidence

Coding Contracts
Verbal Contracts
Contract Decisions ? The Details
Contract Decisions ? Other Information
The Director's Concerns
Contract Management in Health Care
Maintaining the Contract
Commitments
The Business Associate Agreement
Business Associates

Building a Successful Coding/Consulting Business
Establishing Priorities
Facility Requirements
Developing Good Working Relationships
Getting and Retaining Clients
Selecting Clients
Moonlighting ? Don't Quit Your Day Job Just Yet!

Professional Ethics and Compliance
Coding Principles
Where to Find Answers to Coding Questions
Unethical Coding
Ethics for Outpatient Coders
Ethics in the DRG System
The CPT System
Other Coding Concerns
Optimization Through Quality Coding
Coding with Appropriate Documentation
How to Apply Codes
When Not to Code
Documentation Concerns

Compliance and Quality Improvement
Maintaining Confidentiality
Confidentiality and Home-based Coding
Doing Business Under HIPAA
The Privacy Rule
The Business Associate
The Business Associate Agreement (BAA)
Important Coding Security and Privacy Issues
Faxing Health Care Documents
Online Information Security
HIPAA Compliance Policies and Procedures
HIPAA Compliance Training
The Security Rule
Disaster Recovery
Keeping Records
Coding ? Daily Log Sheets/Audit Control of Work Flow
Resources for This Section

The Independent Contractor
Benefits to Independent Contractors
Risks to Independent Contractors
Independent Contracting and the Twenty Common Law
Principles
The Six Factor "Economic Realities" Test
The Reality Check
Subcontracting
Assistance from the Chamber of Commerce
Having the Appropriate Documents in Order
Additional Reference Materials

Finances
Financial Needs and Capital Investment
Watching Your Costs and Expenses
Using a Business Credit Card
Equipment ? Leasing or Renting Versus Buying
Leasing Equipment
When Not to Lease Equipment
Paying Yourself
Tax Incentives: Business Taxes
Types of Taxes
Federal Taxes
Form 1099 and Your Business Income Taxes
Tax Deposits
Social Security Taxes (FICA)
Checking Your Social Security Record
Employer's Identification Number (EIN)
Estimated Tax Payments ? A Horror Story!
State Taxes
Home-Sweet-Tax Deduction
When the Home Office Deduction Is Not the Best Option
Automobile Expenses
Interest on Car Loans
Who Should Lease and Who Should Buy a Car?
Business-related Travel Expenses
Education Expenses
Expensing and Depreciation
Records Needed for Tax Purposes
Tax Sheltering Through Retirement Plans
Simplified Employee Pension (SEP)
Individual Retirement Account (IRA)
Health Insurance
Should You Hire an Accountant, Bookkeeper or Tax Preparer?

The Future of Coding in Health Care

Favorite References and Resources
Associations
Websites
Bibliography
Journals and Publications

Glossary

Appendix

Exhibit I - AHIMA Code of Ethics 2004
Exhibit II - AHIMA Standards of Ethical Conduct
Exhibit III - AHIMA Statement on Health Information
Confidentiality
Exhibit IV - AHIMA: Confidential Health Information and
the Internet
Exhibit V - HIPAA Security Guidance
Exhibit VI - Business Cards
Exhibit VII - Record Completion Log
Exhibit VIII - DRG Optimization Worksheet
Exhibit IX - DRG Contracting Worksheet for Chart Review
Exhibit X - DRG Optimization Summary Worksheet
Exhibit XI - Personal Time Sheet
Exhibit XII - Billing/Invoice Form
Exhibit XIII - Invoice Form for DRG Contracting
Exhibit XIV - Sample Business Associate Agreement
Exhibit XV - Sample Coding Contract
Exhibit XVI - Schedule A ? Fee Schedule
Exhibit XVII - Schedule B ? Nondisclosure Agreement
Exhibit XVIII - Coding Summary #1
Exhibit XVIX - Coding Summary #2
Exhibit XX - Coding Summary #3
Exhibit XXI - Coding Summary #4

Index