This one is for me. CPC exam and other stuff. This student says, “I’m currently studying for the CPC. Is there any advice about other stuff that is required to know like the business of medicine, OIG work plan, RVUs? I can grasp everything else, but for some reason, those sections are meant to block any advice.”
Yeah, in our Physician-Based Coding Course Chapter 1 covers these topics and you’ll also find it in the AAPC CPC Study Guide. They have on the AAPC website – we’ll just go there first to show you what I’m looking at. When you go under Certification and then CPC and you scroll down… actually the first tab here. It tells you the areas, the topics that they test you on. We’ll there’s one here Practice Management, that’s kind of a generic catch-all category. There’re about 9 to 10 questions out of the 150 questions on it. Those are some of the things that she mentioned in her question that will be on it.
So, I basically went through Chapter 1 of the textbook which is the AAPC’s textbook for Physician-Based Coding. They have Types of Payers, so they feel it’s important for you to understand the difference between government payers like Medicare and Medicaid and private payers. It goes into talking about the Medical Record and what does an E/M note look like? They discuss the SOAP format – Subjective, Objective, Assessment, Plan. Then they talk about Operative Report documentation. So, anything on these general topics for CPC Exam could be in that section on the board exam.
Medical Necessity – Basically, Medical Necessity equals your diagnostic coding which makes Alicia very happy. It makes diagnostic coding important to support the procedure that was done which ties in with your local carrier decisions that Medicare puts out there so you can know for any given procedure what diagnoses codes support that procedure where Medicare would consider paying for it. So, they want you to have some familiarity with that.
Advance Beneficiary Notice (ABN) – That’s something that you have a patient sign if you know or suspect that a service is not going to be covered because maybe they don’t have one of those diagnoses on the list. By the way, those diagnoses on the list are not a shopping list for us to use as coders to say, “OK, we will use this one.” You’re supposed to be coding with the physician documented their diagnosis is. Then, if that is not on the approved list, that’s when you have a patient fill out an Advance Beneficiary Notice (ABN).
Then we’ve got HIPAA, The Health Insurance Portability and Accountability Act. It talks about national standards/code sets that everyone is supposed to be using. It also has a portion about privacy and security. So, anyone who’s going to the doctor, they’ll say, “Oh you need to sign this form for HIPAA.”
Then the HITECH Act. I’m going through this quickly because my end advice… OK, Compliance and the OIG – the Office of the Inspector General.
My advice for all of these is just do a Google search, quite honestly. You don’t need to know for the board exam any of these in-depth, but you should be familiar with them so they don’t seem like complete Greek.
So, in this webinar, all of these would probably take several hours to go through and do a lecture on. If you take the course and you’ll get the lecture there, but I would just do a Google search. A lot of this information you’ll find in the CMS website. And do some research that way.
I just did a webinar yesterday about “How to Be Your Own Consultant Using Research Tools Online.” I’m going to get a recording of that and be offering that to our group as well for CEUs, and so look for that. And I show you how you can use things to start… just pretty much how Alicia and I go and research the answers to these questions we give you. Nine times out of ten we start with the Google search or we go to our encoder and we just start pulling pieces of information together and we synthesize it and then present it to you. That webinar will teach you how to do it for yourself, and you can use that to go and explore these topics to prepare for those ten questions on the exam or just for general knowledge.
By the way, a lot of these overlap with the CPC-H credential, with the Physician Practice Management credential; so it does benefit us all to understand these concepts. Now, if you join our discussion forum CodingCertification.Org/forum or our email list which is a Yahoo group’s email list. This kind of stuff comes up all the time. People start taking about HIPAA and they talk about compliance. That’s how I learned back in 1999 when I got my credential. I started an email list called CRNL which we recently changed the name to CCOL because it’s still my list. And they talk about the stuff all the time, like what is that? So, I Google it and I go, “Oh, now I know what that is.” And if someone was stuck on something and they ask a question, I’d watch how others with more experience answered it. That’s really the best way to learn. So, get on our forum and our email list and you will be educated whether you want to be or not.
Then, she’d also asked about RVUs. I don’t recall that being on the exam. If anyone has recently taken the exam, if you want to put in the chat whether or not you remember a question on RVUs; I mean, we can’t talk about specific questions but I really don’t remember them asking about that. But, I did cover it on the other slide with the NCCI Edit. It’s a relative value unit. It’s basically a way to compare one CPT code to another to know the weight of it.
Alicia, you’re up.
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CPC, CPC-I.,Sr. Instructor for CodingCertification.Org. Resides in southern New Jersey with her husband of over 20 years Anthony and four children. They are active foster parents and spend most of their time these days just being parents which they love.
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