Influenza

Vaccines

 Some important terms to remember this flu season

  • Quadrivalent- a vaccine designed to protect against four different flu viruses
  • Trivalent– a vaccine designed to protect against three different flu viruses
  • IM injection- intramuscular typically injected into the deltoid muscle(CDC,2017)
  • Intranasal route– also referred to as flu mist is administered as a spray into the nasal cavity to be inhaled. (CDC,2017)
  • ID injection– intradermal injection is similar to that of a TB test where the vaccine is injected into the skin rather than the muscle(CDC, 2017)
  • Whole Virus– The virus is
  • Split virus- the virus has been interrupted by detergent(WHO, 2017)
  • Subunit virus- The virus has been purified by removal of some parts of the virus(WHO, 2017)
  • Preservatives versus preservative free-
  • Pandemic- Widespread outbreak of the flu, worldwide or nationwide
  • Epidemic—fast onset of outbreak of flu in small communities

Immune system overview

Our immune system works to keep your body in homeostasis by protecting it from foreign invaders, infectious diseases agents(pathogens), and more

The two components to immune system is

  • ACTIVE IMMUNITY
  • PASSIVE IMMUNITY

Each can then further be broken into two components

  • NATURAL
  • ARTIFICIAL

Active Natural immunity is when a person is exposed to a disease or pathogen that activates the immune system to respond to foreign invader entry.

Example: a classroom full of people one person enters the room with the flu virus, contagious—coughs and sneezes in the room exposing everyone to the flu virus. Everyone else in the room even though is unaware of what is going on, their immune response is in high gear to help keep them from getting sick although most will succumb to it and get sick

Active Artificial immunity is when a person elects to get a vaccine, this tricks the body into thinking it has actually been exposed to the disease and activates the immune system to respond to the foreign invader

Example: seasonal flu vaccine is administered to John, he goes home and feels a little under the weather the following 24-48 hours but after that, he feels all better. During the first 24 hours, the body’s immune system begins to respond as if John had actually been exposed to the flu from a contagious coworker. Johns immune system begins creating antibodies to protect against the flu virus so if he happens to actually come in contact with the flu in the future he will be protected at the most and at the least will not have bad effects from the flu

Passive natural immunity is when a mother gives to her newborn baby

Example: while the baby is connected to the mother through the umbilical cord and placenta the mother passes immunity through to the baby. After the baby is born breast milk is packed full of immunity building properties that is also passed from mother to baby.

Passive artificial immunity is when a person receives an immune globulin to prevent devastating effects from diseases like tetanus or rabies

Example: John is walking in the woods at night when he gets attacked by a raccoon, he immediately goes to the ER to have a rabies shot, this is an immune globulin which will lessen the effects from the bite of the rabid raccoon

How long does the protection last?

It is important to remember especially during flu vaccine season that active immunity takes time to fully work. This is the reason that some think that the flu vaccine makes people sick, someone gets the flu vaccine and the next week gets sick—active immunity has not had sufficient time to get activated properly in a person’s system and thus the person gets sick it has nothing to do with the vaccine itself. Active immunity provides long-lasting protection against diseases and pathogens

Passive immunity provides an immediate protection but does not last as long as active immunity, passive only provides protection for a few weeks to a month.

Does getting a flu vaccine increase one’s chances of getting autism or getting the actual virus and getting sicker!

Vaccines have long been controversial, why would one voluntarily inject a virus into their bodies? Vaccines actually make people sicker why would I get one? Vaccines cause children to develop autism, why should children get vaccines?

According to Autism speaks there is no direct connection between vaccines and autism spectrum disorders.

Too many children die every year because of vaccine-preventable diseases and everyone should take vaccines to protect themselves and their families

Some people cannot take the vaccine because of medical conditions or religious exemptions these people need everyone who can take the vaccine to take it so to help protect them too in something called herd immunity

Get your vaccine

protect yourself

protect your family

protect your community

References:

https://www.cdc.gov/vaccines/vac-gen/immunity-types.htm

http://www.who.int/biologicals/vaccines/influenza/en/

https://www.cdc.gov/flu/protect/vaccine/qa_intradermal-vaccine.htm

https://www.cdc.gov/flu/protect/vaccine/quadrivalent.html 

 

Cardiovascular Anatomy

A high pressure one-way system that supplies blood and oxygen to the lungs and the body

The heart is a major muscular pump that constantly pumps blood throughout the heart, lungs, and body

The heart has 4 chambers or rooms the two upper chambers are called the atrium and the two bottom chambers are called the ventricles

Valves are like doors that open and close(this creates the heart beat sound that we hear through stethoscope)  valves are between each chamber in the middle of the walls or septum that divides the heart into the four parts

The heart has 2 departments the plumbing and the electrical part, the vessels are the plumbing and the pacemaker is the electrical portion which keeps the heart in normal rhythm and allows it to pump blood through the vessels.

Hint: cardiologists typically specialize in one or the other just like you wouldn’t call a plumber to change your light bulb a cardiovascular surgeon would not typically deal with the electrical component of the heart they leave that to an electrophysiologist.

Types of vessels

Artery- muscular tube that carries blood away from the heart

Vein- think non-muscular tube that carries blood to the heart

Capillaries- a bridge between arteries and veins

Check out the education page for worksheets, coloring pages, power points and video lectures (coming soon)

Danielle

The profession is changing as we knew it

For what seems like a lifetime ago when medical practices still had paper charts and were just getting ready to implement an EMR program to their practice Medical coders were solely responsible for inputting codes and getting proper reimbursement for the medical practice.

Fast forward to present day, the daily work load of coders has changed as they knew it. Coders are now not responsible for inputting codes but rather spot checking the codes that their provider has already assigned. Yes, you read that right, Physicians are submitting their own codes!

Why?

Many feel that physicians are not responsible for the business side of medicine, that is what coders went to school and took certification tests for! I, myself agree with that statement but also I feel it is important to keep physicians in charge of their own coding.

Inside the encounter, the physician is the only one who knows what happened exactly and should then be the one to assign codes for the encounter. Something has to be done to help them though because more time is being spent on data entry, documentation, and coding than direct patient care, this is a problem.

With all of that being said, there is still a big need for certified coders, just know that what was once a job to just assign codes has now changed to more of a charge entry biller coder. Once the provider enters a code the code is not submitted to the insurance company until it goes to you the coder, your responsibility is to check the provider code is it right, is it too high or is it too low? You will have the chance to edit the code selection and then you will submit the code to the insurance company to be billed.

Providers need to be involved in the medical coding process, because of this statement providers need to be educated on documentation and how to assign codes. There are many educators out there, make sure before recommending an educator to your provider that you check credentials of the educator.

You will want to look for someone who has an instructor certification through the AAPC (CPC-I) an auditing credential(CPMA) and specialty credentials

Want more information on how Americode can help?  Go to our contact page

Happy Coding

Danielle

Understanding HCPCS

HCPCS stands for Healthcare Common Procedural Coding System

There are 2 levels associated with HCPC coding system, level I is found using the CPT manual and level II is found in the HCPCS manual

HCPCS are used to bill products, supplies, and services that are not found in the CPT manual.

Examples of what is found in HCPCS

  • Ambulance services
  • DME
  • Prosthetics
  • Orthotics
  • Supplies
    • Tubes
    • Syringes
    • Monitoring equipment
    • Gauze
    • Bandages
    • Splints
    • And more
  • Drugs

HCPCS are alphanumeric codes

  • Ambulance codes and medical/surgical supplies
  • Enteral and parenteral therapy
  • Outpatient PPS
  • Dental
  • Durable Medical Equipment
  • None
  • Procedures and professional services
  • Alcohol and drug abuse treatment
  • None
  • Drugs administered other than by oral route
  • Durable Medical Equipment- MACS
  • Orthotic procedures and services
  • Medical Services
  • None
  • Pathology and laboratory services
  • Temporary codes
  • Radiology services
  • Temporary national codes
  • National codes established for state Medicaid agencies
  • None
  • Vision services

HCPCS also has a variety of modifiers that need to be noticed for such circumstances like anatomical location, anesthesia services, and other services these modifiers can be used with HCPCS and CPT codes. Make sure you do not miss these as you are submitting procedural and service codes.

Happy Coding

Danielle

Anesthesia Coding

Make sure when you are coding for anesthesia services and are looking up codes in the CPT book index look anesthesia and then the procedure for example

If you need to code for anesthesia for major abdominal vessels you would look up anesthesia then abdomen then blood vessels and get 00880

Anesthesia

Abdomen

              Abdominal wall……..00700, 00730

00800-00800, 00820, 00836

Blood vessels………… 00700, 00880-00882

Billing Anesthesia Services

When calculating anesthesia time you will want to remember this formula

Anesthesiologists and CRNA’s

(Base factor + Time units)X anesthesia conversion factor X modifier adjustment= allowance

(B+T)XCFXMF=Reimbursement

Anesthesia by surgeon/provider

[(base factor + time units) X Anesthesia conversion factor] X modifier adjustment= allowance for each provider

[(B+T) XCF] X MF= reimbursement

 

Try Coding  some anesthesia scenarios  here  (coming soon)

What an Honor

I made the presidents list

I cannot believe that I am almost finished with my Master’s degree! Seems like yesterday I began my journey in Public Health. I love that I have learned something new and useful every quarter! My most dreaded quarter was actually not that bad in reality, and I learned a lot! I decided then if I could conquer Biostatistics I could conquer anything that comes my way! I wanted to write this post today to give everyone some hope and encouragement if you are currently enrolled in a college course, keep up the good work, hang in there it will be over before you know it!  I have several times throughout the past year and a half had thoughts of I just wanted to be done, I needed a break, but I pushed through and continued and now I am looking at 2 more quarters I can definitely see the light at the end of the tunnel!!!

It has been super time consuming it seems that the only thing I do is study, read, write, go to work, study, read, write, eat dinner, study some more sleep and then do it all over again the next day, I am totally consumed with school and anyone who knows me knows this fact—my social life is at an all time low I constantly have my nose in a book or knee deep in my research but when you are passionate about the subject it makes it easy to deal with!

I was so surprised at the end of last quarter I received an e-mail from the school president that said I had made the Presidents list, what an honor, all of my dedication and hard work has paid off, I am now looking to graduation and wanting to maintain my standing on the Presidents list!

Keep up the hard work, persevere, you will make it and be successful!

Stay positive

Happy Vibes

Danielle

Overview of Cardiovascular Section

Cardiovascular coding is a complex area of specialty

Codes for cardiovascular specialty can be found in three parts of the CPT and also the HCPCS

  1. Cardiovascular surgery is found in the surgical section/ green section of the CPT part of the 30000 series right after respiratory section
  2. Non-invasive diagnostic tests can be found in the Medicine section- this is also a green section found right after the path and lab section (last blue section)
  3. In order to perform non-invasive tests, radiology equipment must be used and these codes are found in the radiology section which is the red section after surgery and before path and lab
  4. Cardiovascular surgical equipment and supplies will be found in the HCPCS (holter monitor, pacemakers…)

It is very important to understand the anatomy, physiology, pathophysiology, and terminology of the cardiovascular system we will be covering each of these topics in blog posts to follow

Remember that as you are coding in this section to pay very close attention to parenthetical statements, guidelines, and notes as to be sure to correctly assign codes.

Your highlighter will be your best friend in this section