HEALTHCARE. BUSINESS MONTHLY Coding Billing Auditing Compliance Practice Management. Become a PapNap Mystery Solver: 16

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1 HEALTHCARE BUSINESS MONTHLY Coding Billing Auditing Compliance Practice Management February Become a PapNap Mystery Solver: 16 Search for proper billing clues of C-pap sleep studies Toxicology Requisition Forms for Today: 52 Yesterday s forms are a compliance issue Cut the Fluff in the Hiring Process: 54 Hiring professionals get real with expectations

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3 COVER Auditing/Compliance 44 Corporate Wrongdoing Falls on the Individual By Robert Pelaia, Esq., CPC, CPCO, and Jamie Ewing Healthcare Business Monthly February 2016 [contents] Coding/Billing Auditing/Compliance Practice Management 20 Coding Sclerotherapy of Fluid Brad Ericson, MPC, CPC, COSC 52 Have Compliant Requisition Forms for Pain Management Drug Testing Frank Mesaros, MPA, MT (ASCP), CPC, CPCO 54 What Employers Really Look for in a Job Candidate John Verhovshek, MA, CPC [continued on next page] February

4 Healthcare Business Monthly February 2016 contents Added Edge 14 Don t Let Your Credentials Slip Away Michelle A. Dick Coding/Billing 16 Solve the PapNap Mystery Jill M. Young, CPC, CEDC, CIMC 18 Know Where Your Physician Is Renee Dustman 22 Prolonged Services Updates and Other 2016 E/M Changes Michael Strong, MSHCA, MBA, CPC, CEMC 26 Reinforce Knee Arthroscopy Coding Sarah Wiskerchen, MBA, CPC 32 Make the Most of HCCs Colleen Gianatasio, CPC, CPC-P, CPMA, CPC-I 36 Don t Lose Sleep Over Medicare Billing Intricacies of Sleep Apnea Treatment Andrew H. Selesnick and Stacey L. Zill 40 Move Over 2015 Vaccine Coding Karla M. Hurraw, CPC, CCS-P 42 Get the Message to Your Clinicians Suzan (Berman) Hauptman, MPM, CPC, CEMC, CEDC Auditing/Compliance 48 Comprehend Comprehensive Care for Joint Replacement Payment Stacy Harper, JD, MHSA, CPC Coder s Voice 58 Tap into the Value of the CPC-A Ken Camilleis, CPC, CPC-I, COSC, CMRS, CCS-P COMING UP: OIG Work Plan Revenue Opportunity Shoulder Arthroscopy 2016 Path and Lab Category III On the Cover: Robert Pelaia, Esq., CPC, CPCO, and Jamie Ewing explain how the Yates Memo provides a renewed focus on individual accountability in corporate misconduct. Cover illustration by Kamal Sarkar. DEPARTMENTS 7 Letter from CEO 8 Letters to the Editor 9 I Am AAPC 10 NAB Committee News 12 AAPC Chapter Association 30 Chat Room 34 Alphabet Soup 66 Minute with a Member EDUCATION 60 Newly Credentialed Members Online Test Yourself Earn 1 CEU healthcare-business-monthly/archive.aspx 4 Healthcare Business Monthly

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6 Serving 153,000 Members Including You! vendor index Go Green! Why should you sign up to receive Healthcare Business Monthly in digital format? Here are some great reasons: You will save a few trees. You won t have to wait for issues to come in the mail. You can read Healthcare Business Monthly on your computer, tablet, or other mobile device anywhere, anytime. You will always know where your issues are. Digital issues take up a lot less room in your home or office than paper issues. Go into your Profile on and make the change! American Medical Association Billing-Coding, Inc HealthcareBusinessOffice, LLC ZHealth Publishing, LLC HEALTHCARE BUSINESS MONTHLY Coding Billing Auditing Compliance Practice Management Director of Publishing Brad Ericson, MPC, CPC, COSC brad.ericson@aapc.com Managing Editor John Verhovshek, MA, CPC g.john.verhovshek@aapc.com Editorial Michelle A. Dick, BS Renee Dustman, BS Graphic Design Mahfooz Alam Kamal Sarkar Advertising Jon Valderama February 2016 Address all inquires, contributions, and change of address notices to: Healthcare Business Monthly PO Box Salt Lake City, UT (800) Healthcare Business Monthly. All rights reserved. Reproduction in whole or in part, in any form, without written permission from AAPC is prohibited. Contributions are welcome. Healthcare Business Monthly is a publication for members of AAPC. Statements of fact or opinion are the responsibility of the authors alone and do not represent an opinion of AAPC, or sponsoring organizations. CPT copyright 2015 American Medical Association. All rights reserved. Ask the Legal Advisory Board From HIPAA s Privacy Rule and anti-kickback statute, to compliant coding, to fraud and abuse, there are a lot of legal ramifications to working in healthcare. You almost need a lawyer on call 24/7 just to help you make sense of all the new guidelines. As luck would have it, you do! AAPC s Legal Advisory Board (LAB) is ready, willing, and able to answer your legal questions. Simply send your health law questions to LAB@ aapc.com and let the legal professionals hash out the answers. Select Q&As will be published in Healthcare Business Monthly. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The responsibility for the content of any National Correct Coding Policy included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse or interpretation of information contained in this product. CPT is a registered trademark of the American Medical Association. CPC, COC TM, CPC-P, CPCO TM, CPMA, and CIRCC are registered trademarks of AAPC. Volume 3 Number 2 February 1, 2016 Healthcare Business Monthly (ISSN: ) is published monthly by AAPC, 2233 South Presidents Drive, Suites F-C, Salt Lake City UT , for its paid members. Periodicals Postage Paid at Salt Lake City UT and at additional mailing office. POSTMASTER: Send address changes to: Healthcare Business Monthly c/o AAPC, 2233 South Presidents Drive, Suites F-C, Salt Lake City UT Healthcare Business Monthly

7 Letter from CEO While Most are Hibernating, Stay Connected In February the middle of winter communication becomes more essential than usual. This is especially true in our industry as each year s new regulations and code sets are implemented. Thirsty for guidance, we look to our peers, to payers, and to regulators every day. AAPC offers many ways to stay connected through Member Forums, Local Chapter meetings, social media, webinars, publications, and regional and national conferences. The ability to find a colleague who might have the answer, who knows why it matters, and who wants to help you succeed is exciting. I m excited about HEALTHCON, April at Walt Disney World s Coronado Springs Hotel in Orlando, Florida, for that very reason. There are few occasions in our industry where so many can meet to share, listen, and learn. The platform annual national conference attendees enjoy is broad and unique. HEALTH- CON presenters educate on the latest in coding, billing, compliance, auditing, and practice management. HEALTHCON 2016 covers a broader spectrum of knowledge for the business of healthcare industry than ever before. You ll find topics you want to learn about, no matter what your job title. The Human Touch New sessions are only part of the story. The popular Anatomy Expo and Business of Healthcare Expo return, along with the Minute to Win It game. Fellowship is one of the major reason members like HEALTH- CON. We are all among our own. For most, AAPC membership means more than carrying a card and getting a magazine, it means being part of a network of professionals. One AAPC professional will be missed this year: Former National Advisory Board Chair Terry Leone, CPC, CPC-I, CPC-C, CIRCC, passed away January 1. A pioneer in our field, Terry was passionate about coding and coders. His work on behalf of AAPC members, along with his good humor and expertise, helped make AAPC and our members integral to the healthcare system. He represented all members with overwhelming humility and grace, and he made sure, at a time when our industry turned more toward computers, the humanity remained. Healthcare information management veteran Sheri Bernard, CPC, COC, CCS-P, told us, I knew Terry for many years, first on the National Advisory Board, and later when he was the NAB president and I was at AAPC. He was a great coder, astute business leader, and a loyal friend. He lead the NAB during a time of great change at AAPC, and his advice and counsel was invaluable. AAPC is what it is because of Terry, but he wouldn t want the spotlight solely on his efforts. AAPC is what it is because each member contributes in his or her way to the field. This is done through the core skill of AAPC s membership: communication and networking. I m grateful to be part of an organization where members not only work together to share knowledge but also have passion for improving healthcare for the whole country. I look forward to seeing you in Orlando, meeting you at local chapters, and speaking with you at regional conferences. AAPC is all about communication, and I m glad that s the case. Sincerely, Jason J. VandenAkker CEO HEALTHCON presenters educate on the latest in coding, billing, compliance, auditing, and practice management. February

8 Keep revenue roads clear of denial roadblocks Protect patients from losing their medical identities Qualified scribes can streamline processes December Letters to the Editor Please send your letters to the editor to: HEALTHCARE BUSINESS MONTHLY Coding Billing Auditing Compliance Practice Management Let Blood Transfusion Payment Flow: 25 Watch Out for Identity Thieves: 42 Note Medical Scribes: 50 Watch Your Digits for Blood Transfusion ICD-10-PCS Codes I was looking at Blood Transfusion: Document Properly for ICD-10-PCS (December 2015, page 25), and found a typo regarding the correct code for the red blood cell transfusion accessing a percutaneous peripheral vein using nonautologous cells. The article cites 3023N1, but the code should be seven characters: for example, 30233N1 Transfusion of nonautologous red blood cells into peripheral vein, percutaneous approach. - Jennifer Freeman Terrance C. Leone: AAPC Loses a Leader, Friend AAPC s first male National Advisory Board (NAB) president, Terrance Terry C. Leone, CPC, CPC-I, CPC-C, CIRCC, of Palmyra, New York, passed away on January 1, 2016, at the age of 66. Terry was owner of medical billing and coding company Catamount Associates and led the AAPC NAB from He became involved in AAPC in 1997, when coding teachers were far and few between. During Terry s tenure as AAPC NAB president, he was most recognized for being the first male in that leadership position and for helping AAPC reach its 100,000 member goal. To put in perspective what a rarity men were in our industry, Terry said, There were five guys and we always talked to each other because there were only five of us. ( NAB Leadership Born from Coding, Coding Edge, April 2009) Terry became a radiology tech in 1967, then moved into interventional radiology, and became involved in orthopaedics coding, as well. Even as a business owner, he personally coded these three medical specialties on a daily basis. He was a downto-earth and sincere leader, with a knack for putting on a captivating presentation when teaching coders about our trade. In his last letter as NAB president (Coding Edge, March 2011), Terry said his personal goal as president was to meet each and every one of you, shake your hand, and ask where you were from. Although I didn t reach that lofty goal, it was an honor and a pleasure to shake the hands of those many members I did meet. AAPC feels the loss of Terry s passing. AAPC Vice President Strategy and Development Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC, said, This great man is no longer with us. Terry was a great leader, a passionate and compassionate past board president. I was proud to call him friend and mentor. May God bless his family. Need an official answer? AAPC - Advertising Ask an AAPC Expert Visit aapc.com/ask-an-expert to get expert answers to your healthcare questions. Whether you are settling a coding dispute or need a response from a reputable source, AAPC Ask an Expert provides the answers you need. Post a coding, billing, auditing, practice management or compliance question and receive a response from an AAPC Expert within one business day. The AAPC Expert team includes professionals from all facets of the business of healthcare. Get answers to tough questions from a source you can trust. 8 Healthcare Business Monthly

9 I Am AAPC SYLMONIA RENEE JENKINS, CPC-I, CPC chose to work in healthcare because I really enjoy helping people. I started as a worker s I compensation collector in patient accounts at Columbia St. Mary s Hospital. The job had its challenges, but no matter how difficult the claim, I never gave up until it was paid. Follow Up Required Coding Know-how Worker s compensation claims were often denied due to coding errors. For me to conduct proper follow up, I needed to understand the coding part of the bill, so I pursued medical coding. After graduating from Bryant & Stratton College, I was ready to earn my Certified Professional Coder (CPC ). Or so I thought. The exam was very difficult; I wasn t able to finish in time. My heart was broken, but I didn t give up. AAPC gave me a second chance to take the exam and I passed. I was overjoyed! Tough Lessons Ahead With a new credential tacked to the end of my name, I started my job hunt. My excitement and enthusiasm quickly diminished as door after door closed in my face due to lack of coding experience. Two years later, I still hadn t found work as a coder, so I gave up. I didn t renew my CPC credential; I just quit. Shortly after I made that decision, I was offered a position at a different company as supervisor of Accounts Receivable. I worked closely with medical coders, and I knew I made a huge mistake letting my CPC lapse. I took a coding refresher course. Later, I was offered a position as coding supervisor at the same company and I accepted albeit reluctantly because I wasn t a certified coder. I was so angry with myself for not keeping my CPC ; it was one of the biggest mistakes I d ever made. Nonetheless, I completed the course, and with fingers crossed, I passed the exam. #IamAAPC #IamAAPC Healthcare Business Monthly wants to know why you chose to be a healthcare business professional. Explain in less than 400 words why you chose your healthcare career, how you got to where you are, and your future career plans. Send your stories and a digital photo of yourself to: Michelle Dick (michelle.dick@aapc.com) or Brad Ericson (brad.ericson@aapc.com). Back in the Game Earning my CPC a second time opened many doors for me. I networked with other healthcare professionals at a leadership seminar, and the dean of Milwaukee Career College invited me to speak to students to share my story of how I became a CPC. I was offered a job as an instructor of Medical Billing and Coding at the college, and I gladly accepted. After my job ended at the college (due to low student enrollment), I remembered meeting an awesome individual, Adrianne Lovett, PhD, MBA, CCS-P. I applied for a job at the company Adrianne worked for, Aurora Healthcare, in Milwaukee, Wisconsin, and she hired me as a coding education auditor in billing administration. A year later, I accepted a position as a coding instructor. Once again, I was in a position where I had to pass an exam. I have to admit, I was anxious. Thankfully, I earned my Certified Professional Coder-Instructor (CPC-I ). Never Throw in the Towel I enjoy my role as coding educator. I share my story with new coders when they threaten to throw in the towel. Define your dream and ignite a burning desire to achieve it. As motivational speaker Earl Knightingale said, You become what you think about most of the time. February

10 NAB COMMITTEE NEWS By Angela Clements, CPC, CEMC, COSC, CPC-I, CCS Regional Spotlight: Region 5 - Southwest Two representatives team up to promote, serve, and support AAPC and its Region 5 members. is hard at work innovating the business side of healthcare to support its 150,000-and-growing membership, AAPC as well as the healthcare industry. To ensure members needs are not overlooked, AAPC relies on the National Advisory Board (NAB) to serve as liaison. Knowing who your local NAB representatives are is essential for an optimal membership experience. Over the next few months, we ll spotlight each of the NAB representatives in the eight regions, beginning with Region 5. We hope you take advantage of the services your regional representative offers you as an AAPC member. Note: NAB Committee News is a new column that first appeared in the January 2016 issue with the article, The National Advisory Board Is Here to Serve You. Region 5 Southwest The Southwest region is comprised of the states Texas, Oklahoma, Missouri, Kansas, Louisiana, Arkansas, and Mississippi. These seven states are home to over 19,000 members and 66 local chapters. Lori Cox, MBA, CPC, CPMA, CPC-I, CEMC, and Angela Jordan, CPC, are the NAB representatives who promote, serve, and support AAPC and its members in Region 5. They are both from Missouri, but from opposite sides of the state. Cox and Jordan look forward to seeing a strong Region 5 presence at HEALTHCON 2016 in Orlando, Florida. 10 Healthcare Business Monthly

11 NAB Committee News Lori Cox, MBA, CPC, CPMA, CPC-I, CEMC Cox lives in Hannibal, Missouri, where she began her healthcare career as a patient accounts collector for a multi-specialty clinic. She worked her way up to the position of compliance officer before landing her dream job: working from home for Med- Koder. Cox is a coding team leader. Cox has more than 15 years of experience in multiple areas of healthcare, including auditing and compliance. She has been certified since 2002 and has held the offices of vice president and secretary of the Quincy, Illinois/Hannibal, Missouri, local chapter. Cox became a NAB member because she wanted to represent the members of her region to the AAPC national office. She enjoys the networking opportunities that AAPC provides, as well as the educational offerings. Angela Jordan, CPC Jordan lives in Blue Springs, Missouri, and is not only a True Blue CPC, but a trueblue Kansas City Royals fan. She has more than 25 years of experience in the healthcare field, and has been an AAPC member for 15 years. Jordan s career path has taken her from a small family practice, to radiology, and from a large physician services group, to a senior managing consultant position. Jordan recognizes her mentor, Donna Barker, CPC, CPMA, CPC- I, for seeing her potential and introducing her to AAPC. She knows AAPC and her local chapter have played a major role in her career success. Supporting the needs of Jordan s regional members and serving as an ambassador for AAPC allows her to pay it forward. As a member of the Kansas City, Missouri, local chapter since 2003, Jordan has held many officer positions, including president. In 2009, she served as a member of the AAPC Chapter Association board of directors and was chair in Jordan has attained her dream job, working for the founder of the Kansas City, Missouri, local chapter, Sandra Soerries, BS, CPC, COC, at Medical Revenue Solutions, LLC. Making Region 5 Stronger Cox and Jordan both have a passion for their professions and enjoy networking with members from presenting at local chapter meetings, to proctoring exams, to communicating with members through s and social media. Being NAB ambassadors for AAPC members allows them to engage the healthcare community to show the value of credentialed members, as well as to assist Region 5 members in achieving their career goals. Cox and Jordan look forward to seeing a strong Region 5 presence at HEALTHCON 2016 in Orlando, Florida. Whether you see them at the conference or have an opportunity to reach out to them elsewhere, feel free to share your career success stories with them or just say hello. Remember chapter officers: If you re in need of meeting ideas or speakers, your regional representatives are great resources. Cox can be reached at lori.cox@aapcnab.com and Jordan at angela.jordan@aapcnab.com. NAB COMMITTEE NEWS February

12 AAPC Chapter Association By MariaRita Genovese, CPC, PCS Ring in the New Year Philly Style! Let this chapter s enthusiasm be an example to follow in image by istockphoto Delpixart Each new year, we usually recap the previous year and general accomplishments of the AAPC Chapter Association, as a whole. This year, we thought we d change things up a bit and focus on one chapter, in particular: the Philadelphia, Pennsylvania, local chapter. This chapter did a lot of things right in I know because it s my chapter! I hope we inspire your chapter to be innovative and exceptional in Highpoints It helps that we have a dedicated group of officers who are committed to the growth of the chapter and its members. Our mission for 2015 was to offer a variety of topics to encompass all aspects of the business side of medicine, including: Offering two Certified Professional Coder (CPC ) review classes; Proctoring 10 exams; The officers placing a booth at a local job fair to educate the participants about AAPC and to encourage membership in local chapters; Celebrating our 16th year as a chapter; Hosting a successful annual symposium, with a variety of speakers, including Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC; and Hosting several mix and mingle events to encourage networking among our current and new members. Hot Topics Professionalism is always a hot topic in our line of work, which led us to offer a resume workshop. It was well-received, as many members have a difficult time creating a viable resume. We answered questions about to the quality of information that should be provided, and we supplied examples to our members. We offered a session on leadership skills in the spring. This session reviewed leadership styles and how to motivate staff to be part of a company s overall strategic goals. 12 Healthcare Business Monthly

13 AAPC Chapter Association Left to right: Tracy Ervin, Dennis Delisle, MariaRita Genovese, Marcella Cicirello, Maria Stewart Guest speaker Chandra Stephenson, former AAPC National Advisory Board member. Philadelphia chapter members show off their new AAPC swag. We also offered a roundtable discussion to our members. This meeting was to give members an opportunity to inquire about career paths. All of our officers have different positions and careers, and it was very rewarding for us to impart what we ve learned over the years. Helping Hands Our philanthropic efforts in 2015 led us to raise funds for the AAPC Hardship Scholarship program, which aids our fellow AAPC members in times of need. We also collected new hats and gloves for underprivileged children (something we do every year). I think being a busy chapter is a successful chapter -- one you can be proud of. Take pride in your chapter, and be exceptional in 2016! MariaRita Genovese, CPC, PCS, is director of operations, Department of Medical Oncology and Jefferson Infusion Centers, Thomas Jefferson University. She manages a practice of over 50 physicians, two outpatient infusion centers, and a support staff of 200. Genovese has over 20 years of experience in billing and practice management, most recently in the areas of family medicine and medical oncology. She also educates physicians and staff in medical coding and compliance regulations. Genovese serves as president of the Philadelphia, Pa., local chapter, and served as either chapter president or vice president in 2008, 2010, and She is a Region 1 representative of the AAPC Chapter Association and a former member of AAPC s National Advisory Board. February

14 ADDED EDGE By Michelle A. Dick Don t Let Your illostration by istockphoto jorgennac Credentials Slip Away You earned them and have worked way too hard to give up on your dream. There are many reasons why an AAPC member may consider letting go of his or her hard-earned credentials. Sometimes it may seem like the best choice, especially if the member is out of money and hasn t found a job in his or her field. Other times, the decision is made because a member fears taking and failing a proficiency exam. Whatever the reason, it s never a good idea to give up and to sell yourself short. It puts you at a disadvantage when marketing yourself in the industry, and it s a burden to get back into the business side of healthcare without credentials. Before you pack your bags and hit the road, consider the consequences of giving up your credentials. When Letting Go Seems Like the Only Option If you re at the breaking point and think your credentials aren t all they re cracked up to be, consider your actions carefully before you let your credentials lapse. Former AAPC Chapter Association Chair Brenda Edwards, CPC, CPB, CPMA, CPC-I, CEMC, CRC, said she knows members who have let their credentials expire, and they have had nothing but regret. These are members who may or may not use their credentials in their current careers, she said. It s not only a bad career decision for a credentialed member, but it also hurts the teacher, according to Edwards. I have taught a lot of students in the PMCC course and it hurts to hear they have not kept their credentials current, she said. Edwards says her students are like her kids. I have watched them learn and gain experience, and then to find out after all of that, they let them go for whatever reason it s upsetting, she said. AAPC Chapter Association Chair Barbara Fontaine, CPC, said she doesn t know anyone who let his or her credentials expire and who didn t keep current with required education or membership fees. She does know, however, someone who considered it. I know a member 14 Healthcare Business Monthly

15 Credentials When they told me they had let their certifications go, I had to tell them that they were not qualified for the job. who was not going to keep her credentials because she was afraid of the ICD-10 Proficiency Assessment, Fontaine said. The good news is that the member decided at the last minute to take the proficiency, and passed it on the first try. When the member finished the assessment she said that she thought back on how difficult it had been for her to obtain her CPC credential and decided she wasn t going to let all that time, money, and effort be wasted, said Fontaine. For a firsthand story about what can happen when you let credentials run out, read Sylmonia Renee Jenkins, CPC-I, CPC, I Am AAPC story on page 9. Advantages of Holding Tight to Credentials Credentials prove that you have the basic expertise needed for any particular job, Fontaine said. She coded for years before becoming certified. When Fontaine became certified, she said, It was like the whole world of coding and billing opened up for me. Since receiving her credentials, she has been sought out for several positions. Although she is happy at the job she has, she said, It was really flattering to be considered and pursued based on my credential and my experience. Although Fontaine already had her foot in the industry door before she obtained her credentials, it was not the case with Edwards, who always considered coding as her first career choice. Her credentials were a tool she used to land a job and advance her career. Edwards said, I started with no experience. To advance in my career, it has been important for me to always be current on my skills. A lot of hard work and time has gone into each of my credentials. Edwards says if she was to let any of her credentials go, she would be failing herself and failing her career. I believe that credentials aid in credibility with providers, coders, and my students when I teach, she said. Edwards take-home message to members is Credentials are attainable. If I can do it, you can do it. When obtained, credentials should be kept with pride because you earned them and they are marketable. Employers Will Overlook You Coding Manager Pam Brooks, MHA, CPC, COC, PCS, at Wentworth-Douglass Hospital (WDH) in Dover, New Hampshire is responsible for a team of coders and for hiring new coding candidates. She said, Most hospitals (including mine) and larger healthcare organizations require that coders obtain and retain their coding certifications. Brooks says letting your credentials lapse could put you at a disadvantage when looking for work. She has had potential employees ask about job openings but, she said, When they told me they had let their certifications go, I had to tell them that they were not qualified for the job. If You Start Slipping, There s Help There are options if you can t financially keep up with membership dues or Continuing Education Units (CEUs). Here are ways to get free and low-cost CEUs: Local Chapter Meetings/Local Events - When you attend CEU-approved local chapter meetings and local events, you can earn one CEU per hour and enjoy networking with other professionals and possible future employers. Some chapter meetings are free or only cost a few dollars. Test Yourself - Healthcare Business Monthly offers an online Test Yourself quiz ( All you have to do is answer the magazine s questions and you ll receive one free CEU per issue. There are 12 archived Test Yourself exercises available at a time, so you can earn up to 12 free CEUs per year. Write for Healthcare Business Monthly You can earn 0.5 CEUs for every 500 published words you write in the magazine, with a maximum of 1.5 CEUs per article. The Centers for Medicare & Medicaid Services (CMS) - Medicare Learning Network has several web-based programs where you can earn CEUs for free at: (click on the Web-Based Training (WBT) to the left on the webpage). Resource: If you feel you need to let your credentials expire because of financial hardship, you can apply for the AAPCCA Hardship Scholarship Fund that is available for members in need. To apply, contribute, or find out more about the AAPCCA Hardship Scholarship Fund, visit the AAPC website at Michelle A. Dick is executive editor at AAPC. February

16 CODING/BILLING By Jill M. Young, CPC, CEDC, CIMC Solve the PapNap Mystery image by istockphoto stockmachine Hint: They aren t shortened sleep studies. 16 Healthcare Business Monthly have worked with providers who perform sleep studies (polysomnography) for quite some time. Several years ago, a physician asked I me about billing PapNaps. I didn t know much about it, so I did some research. At the time, literature and advertisements for PapNaps indicated that the test was used to desensitize C-pap patients with an abbreviated daytime sleep study and test for compliance when using their machine. Patients would come into the sleep lab during the day, were hooked up to monitoring equipment, and given an opportunity to sleep for two to four hours. Searching for Proper Billing Clues There was very little information on how to bill for this service which does not have a specific CPT code. There is a 2008 article, however, written by Barry Krakow, MD, and published in the Journal of Clinical Sleep Medicine, which physicians reference for billing a PapNap using Sleep study, simultaneous recording of ventila- Coding/Billing Auditing/Compliance Practice Management

17 To discuss this article or topic, go to PapNap If you have been billing for PapNaps, remember that just because you were paid doesn t mean you billed correctly, or that the payer won t ask for the money back. CODING/BILLING tion, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist with modifier 52 Reduced services appended. Krakow indicated that he had spoken with Medicare about billing for PapNaps, but does not indicate that Medicare specifically approved of his methodology. I questioned the medical directors of two Medicare administrative contractors on the topic of PapNaps. They both indicated was not an adequate representation of a PapNap, and appending modifier 52 didn t change that. So why have practices been successfully reporting for Pap- Naps? The answer is simple: Absent a documentation request or audit, the payer believed that a sleep study was performed, but that the patient left prior to the minimum six hours that requires (which is the traditional and appropriate use of this code/ modifier combination). Piecing Together Payer Puzzles Several payers have issued policies or positions on payment of Pap- Naps, which specifically advise against reporting For example, Blue Cross Blue Shield (BCBS) of Alabama states, for dates of service on or after June 13, 2013: the use of an abbreviated daytime sleep study (PapNap) as a supplement to standard sleep studies does not meet Blue Cross Blue Shield of Alabama s medical criteria for coverage and is considered investigational. BCBS of Minnesota came to the same conclusion, stating that Pap- Naps are considered to be investigative due to lack of evidence demonstrating improved health outcomes. The same language can be found in BCBS policies in other states, such as Tennessee. Humana also released a statement that its members may not be eligible for coverage of PapNaps for any indications. Another private payer, Premera, states in its policy, the daytime PAP-NAP desensitization procedure is considered investigational to help patients with insomnia/panic attacks/claustrophobia overcome anxiety about the mask and pressure sensations of the PAP device. Resources: Journal of Clinical Sleep Medicine, Barry Krakow, MD, A daytime, abbreviated cardio-respiratory sleep study (CPT ) to acclimate insomnia patients with sleep disordered breathing to positive airway pressure (PAP-NAP), Sleep Review Preparing for the PAP-NAP, Check with your individual payer, however, as the payer may allow coverage for PapNaps with prior authorization in a limited number of scenarios. Get to the Bottom of It The bottom line is, if you want to perform PapNaps, and receive compliant payment, you ll need to contact your payers to see: 1. If they allow for coverage of this abbreviated study; and 2. How they would like you to bill for the service. As always, get the payer s response in writing. Do not bill Medicare (or any of the insurances cited above as denying this service) for Pap- Naps. If you have been billing for PapNaps, remember that just because you were paid doesn t mean you billed correctly, or that the payer won t ask for the money back. If you were paid for a non-covered service, consult with your healthcare attorney. They may recommend you self-disclose your errors and possibly refund the payments to carriers. Jill Young, CPC, CEDC, CIMC, has more than 30 years of medical experience working in all areas of the medical practice, including clinical, billing, and rounding with physicians. Her expertise is used in several publications and heard on a variety of audio conferences. She speaks at educational lectures for the Michigan State Medical Society and other national organizations, including The Coding Institute and Eli Research. Young has been a workshop presenter for AAPC, and a topic speaker at AAPC National Conference. She has held office for the Lansing, Mich., local chapter and has served on the AAPC Chapter Association board of directors. February

18 CODING/BILLING By Renee Dustman Know Where Your Physician Is Medicare administrative contractors (MACs) require considerable information before they ll pay a claim for services rendered to a Medicare patient. Generally speaking, the claim must include the patient s and physician s identification (who), the procedures or supplies (what), the place of service (where), the date of service (when), and the diagnoses (why). Trouble ensues when any of these essential bits of information are missing or incorrect. Ask any MAC and they ll tell you: The wrong POS code is one of the most common submission errors. image by istockphoto borzaya OIG Is Watching MACs aren t the only entities keeping track of Medicare claims. The Office of Inspector General (OIG) keeps a vigilant eye on the top reasons claims are improperly paid. In the OIG s Work Plan for Fiscal Year 2015, the agency said it was aware physicians do not always correctly code non-facility POS, and that it intended to review physicians coding on Medicare Part B claims for services performed in ambulatory surgical centers (ASCs) and hospital outpatient departments. This isn t speculation on the OIG s part. In October 2004, for example, the OIG audited Wisconsin Physicians Service (WPS) Health Insurance Corporation to determine the extent of Medicare Part B overpayments the MAC made to physicians for billing with incorrect POS codes. The audit showed that Medicare overpaid physicians by as much as $742,510 over two years ( ). Seventy-nine of 100 sampled physician services performed in a facility were billed incorrectly using the office POS code (11). Note: The facility rate is paid for a service rendered to a patient who is an inpatient or outpatient of a hospital, regardless of where the face-to-face encounter between the patient and physician occurred. For the professional component (PC) of diagnostic tests, the facility and non-facility payment rates are the same. (See Medicare Claims Processing Manual, chapter 13, section 150 for POS instructions for the PC and technical component (TC) of diagnostic tests.) Underestimating the importance of a place of service (POS) code can be a costly mistake. 18 Healthcare Business Monthly Why Should You Care? Physicians are paid more for services performed in a non-facility setting, such as a physician s office, than they are for services performed in a hospital outpatient department or ASC. When a physician incorrectly codes the POS, he or she could potentially be paid either too much or too little. Either way, the physician is paid in error and could be accused of Medicare fraud and HIPAA non-compliance. Enter the Right Location The POS code set, maintained by the Centers for Medicare & Medicaid Services (CMS), provides setting information payers need to appropriately pay Medicare and Medicaid claims. Coding/Billing Auditing/Compliance Practice Management

19 To discuss this article or topic, go to POS Codes Note: Both facility and non-facility rates are given in the Medicare Physician Fee Schedule Database (MPFSDB). POS codes for which physicians services are paid at the facility rate include: 19 Outpatient Hospital Off Campus 21 Inpatient Hospital 22 Outpatient Hospital On Campus 23 Emergency Room Hospital 24 Medicare-participating Ambulatory Surgical Center (ASC) 26 Military Treatment Facility 31 Skilled Nursing Facility (SNF) for a Part A Resident 34 Hospice Inpatient Care 41 Ambulance Land 42 Ambulance Air or Water 51 Inpatient Psychiatric Facility 52 Psychiatric Facility Partial Hospitalization 53 Community Mental Health Center 56 Psychiatric Residential Treatment Center 61 Comprehensive Inpatient Rehabilitation Facility POS codes for which physicians are paid at the non-facility rate include: 01 Pharmacy 50 Federally Qualified 03 School Health Center 04 Homeless Shelter 54 Intermediate Health Care Facility/Mentally Retarded 09 Prison/Correction Facility 11 Office 12 Home or Private Residence of Patient 13 Assisted Living Facility 14 Group Home 15 Mobile Unit 16 Temporary Lodging 17 Walk-in Retail Health Clinic 20 Urgent Care Facility 25 Birthing Center 32 Nursing Facility and Skilled Nursing Facilities (SNFs) to Part B Residents 33 Custodial Care Facility 49 Independent Clinic 55 Residential Substance Abuse Treatment Facility 57 Non-residential Substance Abuse Treatment Facility 60 Mass Immunization Center 62 Comprehensive Outpatient Rehabilitation Facility 65 End-stage Renal Disease Treatment Facility 71 State or Local Health Clinic 72 Rural Health Clinic 81 Independent Laboratory 99 Other Place of Service When a physician incorrectly codes the POS, he or she could potentially be paid either too much or too little. CMS updates this list occasionally. You should periodically check the official list, found here: Place_of_Service_Code_Set.html. Latest POS Updates On August 6, 2015, CMS revised the description of POS code 22 from Outpatient Hospital to On Campus Outpatient Hospital, and created POS 19 for Off Campus Outpatient Hospital. POS 19 is effective for any claims processed on or after January 1, 2016, regardless of the date of service. Table A provides descriptions that clarify the terms on campus and off campus. Table A: Newly revised POS codes POS Code Descriptor 19 A portion of an off-campus hospital provider-based department, which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. 22 A portion of a hospital s main campus, which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. There are far more ambiguous elements required for claims payment such as documenting medical necessity that require your attention. Don t let something as basic as a POS code hold things up. Simply enter the correct POS code in Item 24B on the ASC X12N 837 professional standard electronic claim form to identify the setting for each item or service performed. Resources: JMLN Matters Number MM9231 Revised: Learning-Network-MLN/MLNMattersArticles/downloads/MM9231.pdf CMS Transmittal 3315, Change Request 9231: Medicare Claims Processing Manual, chapter 12, section MLN Medicare Quarterly Provider Compliance Newsletter, July 2015: and-education/medicare-learning-network-mln/mlnproducts/downloads/medqtrlycomp- Newsletter-ICN pdf OIG 2015 Work Plan: FY15-Work-Plan.pdf Renee Dustman is executive editor at AAPC. CODING/BILLING February

20 CODING/BILLING By Brad Ericson, MPC, CPC, COSC Uniquely Code Sclerotherapy of Fluid image by istockphoto Bjoern Meyer Don t confuse with separate collection and drainage codes. Sclerotherapy involves injecting a solution (often saline) into blood or lymphatic vessels supplying a lesion. The flow of blood or lymph is redirected, and the lesion shrinks or disappears. Sclerotherapy of a fluid collection is newly recognized in 2016 CPT as Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed. Reporting the Procedure Fluid-filled lymphoceles and seromas can result from surgery, and cysts may form, as well. Data suggests that placing drains during surgery can help to prevent the lesions, but unlucky patients may still develop them. Code describes sclerotherapy for fluid collection of a lymphocele, cyst, or seroma, etc., and includes related contrast injection, diagnostic study, imaging guidance, and radiological suction and irrigation. There are other sclerotherapy codes in CPT, such as those reported for esophageal and gastric varices, hemorrhoids, and veins, but solely reports using the technique for fluid collections. Report one unit of per treated lesion. Append modifier 59 Distinct procedural service to the second and subsequent units. Report a single unit of for connected lesions. 20 Healthcare Business Monthly Coding/Billing Auditing/Compliance Practice Management

21 Sclerotherapy Report one unit of per treated lesion. Example: Mary Louise wondered what she d done to deserve the pain around her brand new kidney. After enduring dialysis for so many years, was her weeks-old organ already letting her down? Mary Louise s lab results were fine for a recent transplant recipient. Her physician thought she felt a lump while palpating the area around the kidney. A quick ultrasound confirmed suspicion: Mary Louise had a large lymphocele in her retroperitoneal area, and it was compressing the kidney. Mary Louise, relieved at the explanation, consented to treatment. During surgery, the physician removed the fluid from the lymphocele with a needle. She then injected the sclerosant and placed Mary Louise in various positions to assure all walls of the cavity were exposed. The sclerosant was removed, and the procedure was performed again. The pain and the lymphocele eventually disappeared, and Mary Louise rested easy. A subcutaneous fluid pocket is aspirated Epidermis Dermis Illustration 2015 Optum360 CODING/BILLING ICD-10: Schematic of layers of the skin I89.9 Disease of lymphatic vessels NOS CPT : Aspiration often comes before Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Multiple procedures CPT gives you two choices when introducing a needle: Puncture aspiration of abscess, hematoma, bulla, or cyst and Isn t Collection Be careful not to confuse sclerotherapy with collection or drainage; doesn t include drainage of fluid prior to sclerotherapy treatment. According to the American Medical Association s (AMA s) 2016 CPT Changes: An Insider s View, drainage represents separate work and should be reported with the drainage procedure code for that particular anatomical site. You may report sclerotherapy and collection/drainage if performed on the same lesion, just as Mary Louise s physician separately reported her services. Bottom line: If an injection was made for collection or a drainage tube was inserted, that s a separate service. For payers who accept it, append modifier 51 to the collection/drainage code to identify it as the secondary procedure performed that same day. Brad Ericson, MPC, CPC, COSC, is director of publishing at AAPC and a member for the Salt Lake City, Utah, local chapter. February

22 CODING/BILLING By Michael Strong, MSHCA, MBA, CPC, CEMC Prolonged Services Updates and Other 2016 E/M Changes Medically unlikely edits add restrictions to these codes. The American Medical Association (AMA) focused on prolonged services for 2016 CPT. New codes were created and guidelines have been updated. Take note, and apply the changes when reporting these evaluation and management (E/M) services. Report Initial Prolonged Service Once, per Day Although medically unlikely edits (MUEs) are commonly implemented by the Centers for Medicare & Medicaid Services (CMS), the AMA has started to implement them with prolonged services. Per CPT instructions added for 2016, Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management or psychotherapy service) and Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient Evaluation and Management service) may be reported only once, per date of service, even if the prolonged service is not continuous. CPT further instructs that prolonged services of less than 30 minutes are not reported separately, and are included in the work of the primary E/M service or psychotherapy code. Time for services other than the E/M or psychotherapy is not counted toward the time for prolonged services. One Psychotherapy Code Is Allowed with Prolonged Services The only psychotherapy service that may be billed with a prolonged service is CPT Psychotherapy, 60 minutes with patient and/or family member. A minimum of 90 minutes must be documented for the encounter (e.g., 60 minutes of psychotherapy, plus at least 30 minutes of prolonged services). Prolonged services codes cannot be reported with CPT Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service (List separately in addition to the code for primary procedure). image by istockphoto geotrac 22 Healthcare Business Monthly Coding/Billing Auditing/Compliance Practice Management

23 E/M Changes The only psychotherapy service allowed with prolonged services is CPT New Codes for Prolonged Services by Clinical Staff Prolonged service may be provided by clinical staff when supervised by a physician or other qualified healthcare provider. The AMA created two new codes for this sort of encounter: CODING/BILLING Prolonged clinical staff service (the service beyond the typical service time) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (List separately in addition to code for outpatient Evaluation and Management service) image by istockphoto Niyazz each additional 30 minutes (List separately in addition to code for prolonged service) Report these services only with E/M codes Report in addition to the primary E/M service for the initial minutes of prolonged clinical staff services (i.e., time in excess of that described by the primary E/M service reported). Per CPT guidelines, report for each additional 30 minutes of prolonged clinical staff services beyond the initial 74 minutes, as follows: Total Duration of Prolonged Services Codes < 45 minutes Not separately reported minutes minutes 99415, minutes 99415, x 2 Time counted toward and does not have to be continuous; however, time spent by clinical staff performing other, separately reportable services does not count toward prolonged services time. Additional requirements for and include: Report once, per date. Neither code may be reported with or For prolonged services provided by clinical staff, documentation must indicate direct supervision by a physician or other qualified healthcare provider. Facilities are restricted from billing these services and cannot be reported for more than two simultaneous patients. Example: A patient returns to her doctor s office for a monthly diabetes check-up. The patient reports no symptoms or other problems, aside from some weight gain. A nurse obtains the vital signs and observes that the patient has gained approximately 10 pounds since last month. Given the standing orders for a monthly fasting glucose and bi-annual A1C, the nurse takes a small sample of blood. Although the patient s blood pressure is 118/76 and pulse is 80, the increased weight gain is concerning due to this patient s history of insulin dependent diabetes. The nurse educates the patient on a diabetic diet and an exercise routine, as requested by the physician. Although the physician did not perform the service, the physician was immediately available in the next room, and supervised the diabetic care instructions. A total of 60 minutes was required to perform the education, obtain the blood work, and conduct the vitals. The services are reported with CPT Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services and February

24 E/M Changes To discuss this article or topic, go to The services are reported for promoting health and preventing illness or injury. CODING/BILLING Other E/M Changes Significant text revisions also were made to counseling risk factor reduction and behavior change intervention. The services are reported for promoting health and preventing illness or injury. The risk factor reduction codes are billed without a specific illness. By comparison, behavior change interventions are reported for the treatment of condition(s) related to or potentially exacerbated by the behavior or when performed to change the harmful behavior that has not yet resulted in illness. These interventions must be used for assessing readiness for change and barriers to change, advising a change in behavior, assisting by providing specific suggested actions and motivational counseling, and arranging for services and follow-up. Any other E/M billed on the same date of service must be distinct, significant, and separately identifiable indicated by appending modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service to the E/M service. Example: A patient presents to the doctor s office complaining of a persistent cough, runny nose, and joint pain. The doctor performs a detailed history, detailed exam, and moderate medical decisionmaking, supporting a Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. The patient is diagnosed with bronchitis. The provider notes there is a family history of cancer and the patient smokes a pack of cigarettes per day. Given the patient s family history and tobacco use, the provider spends 15 minutes educating the patient on the risk of lung cancer due to cigarettes and educates the patient on alternatives for the oral satisfaction obtained from smoking. The provider bills with Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes. Michael Strong, MSHCA, MBA, CPC, CEMC, is the bill review technical specialist at SFM Mutual Insurance Company. He is a former senior fraud investigator and a past EMT-B and college professor of health law and communications. Strong is a member of the St. Paul, Minn., local chapter. He can be contacted at michaelallenstrong@yahoo.com. You Wanted Low Priced CEUs? How about $2.50 per webinar! 12 Months of Access to 40+ Live Events & Entire Library of 100+ On-Demand Webinars Receive 2 CEUs per Webinar (Live & On-Demand) Topics Cover 21+ Specialties 12-Month Subscription Starting at $295 (Volume Discounting Available for Your Office) AAPC - Webinars SAVE $$ Get an Annual Subscription Visit 24 Healthcare Business Monthly

25 Dr. Z's Medical Coding Series Interventional Radiology Coding Reference By David R. Zielske MD, CIRCC, COC, CCC, CCVCT, CCS, RCC Ruth E. Broek MBA, CIRCC, COC, CCS, RTR, CHC & David B. Dunn MD, FACS, CIRCC, COC, CCC, CCVCT, CCS, RCC Dr. Z's Medical Coding Series Vascular & Endovascular Surgery Coding Reference By David B. Dunn MD, FACS, CIRCC, COC, CCC, CCVCT, CCS, RCC & David R. Zielske MD, CIRCC, COC, CCC, CCVCT, CCS, RCC With Ruth E. Broek MBA, CIRCC, COC,CCS, RTR, CHC Interventional Radiology Coding Reference Dr. Z's Medical Coding Series Diagnostic Radiology Coding Reference 2016 Thirteenth Edition 2016 Tenth Edition 2015 Sixth Edition Dr. Z's Medical Coding Series Diagnostic & Interventional Cardiovascular Coding Reference By David R. Zielske MD, CIRCC, COC, CCC, CCS, RCC Ruth E. Broek MBA, CIRCC, COC, CCS, RTR, CHC & David B. Dunn MD, FACS, CIRCC, COC, CCC, CCVTC CCS, RCC 2016 Tenth Edition Dr. Z's Medical Coding Series Cardiothoracic Surgery Coding Reference ZHealth & Ruth E. Broek MBA,RTR By David B. Dunn MD, FACS, CIRCC, COC, CCC, CCVCT, CCS, RCC David R. Zielske MD, CIRCC, COC, CCC, CCVCT, CCS, RCC CIRCC, COC, CCS, CHC 2016 First Edition ICD10 Dr.Z's Medical Coding Series ICD-10 Coding Companion For Interventional Radiology 0W9H3ZXB31R1ZZ 0JPV0XZ 02HV33Z 02HV33Z T8209XA07DR3ZX0T933ZX 3E A W B31R1Z By Sara M. Wolf, BA, COC, CCS, CPMA with Ruth E. Broek MBA, RTR CIRCC, COC, CCS, CHC & Amy E. Hyman, CDIP, CIRCC, CCS, CPMA 2016 First Edition Pre-Order your 2016 Coding Reference Books Now. Interventional Radiology Coding Reference Vascular & Endovascular Surgery Coding Reference Diagnostic & Interventional Cardiovascular Coding Reference Diagnostic Radiology Coding Reference Cardiothoracic Surgery Coding Reference ICD-10 IR Coding Reference CIRCC Study Guide 2016 Can t make the live seminars? We offer the Las Vegas live seminar on video. Earn CEUs Next Live Seminar: Scottsdale in February & May 16-20, 2016 Omni, Nashville visit ZHealthPublishing.com or call With 2016 comes many significant coding changes for non-vascular Interventional Radiology, Vascular, and Cardiology procedures. New bundling guidelines will require added focus to remain in compliance. For 2016, we ve added ICD-10 PCS Interventional Radiology coding companion and Cardiothoracic Surgery coding books. I think you will find these additions invaluable. Thanks - Dr. Z WE ARE NOW SHIPPING February

26 CODING/BILLING By Sarah Wiskerchen, MBA, CPC Reinforce Knee Arthroscopy Coding Proper payment relies on a solid understanding of the guidelines. CPT, GSD, and NCCI Histories The American Medical Association s (AMA) CPT is a set of codes, descriptions, and guidelines intended to define procedures and services. Since 1966, it has been the standard for reporting physician-performed services. The AAOS developed and maintains a supplemental set of coding guidelines for its members. Introduced in 1991 and called the Complete Global Service Data for Orthopaedic Surgery (GSD), the guidelines provide detail regarding what is included in (or excluded from) every orthopaedic CPT code. The GSD guidelines clarify details that may not be evident in the CPT descriptions, but that were applied when the CPT codes were developed. The National Correct Coding Initiative (NCCI) is a program developed by the Centers for Medicare & Medicaid Services (CMS) to prevent improper payment of procedures that should not be submitted together. NCCI was first implemented in NCCI includes a combination of narrative guidelines and code-specific, procedure-to-procedure edits. The edits indicate that two services are never paid together using a designator of 0 and that two services could be paid together if appropriate criteria are met using a designator of 1. NCCI edits are not all inclusive; just because an edit is not present does not mean code sets may be reported together. There are examples in orthopaedics where an NCCI procedure-to-procedure edit exists between codes; several of these examples affect arthroscopic knee procedures. NCCI has also established narrative guidelines more restrictive than CPT parameters affecting knee procedures. Meniscectomy and Meniscal Repairs Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed with meniscus repair (medial OR lateral) Many physicians and coders are confused by the differences among CPT definitions, American Academy of Orthopedic Surgeons (AAOS) Global Service guidelines, and Medicare s National Correct Coding Initiative (NCCI) guidelines and procedure-to-procedure edits affecting arthroscopic knee CPT codes. There also is confusion about when modifier 59 Distinct procedural service is required under each set of guidelines; how the rules apply to Medicare vs. non- Medicare claims; and the impact of the X {EPSU} modifiers introduced in This article clarifies those differences and answers common questions. 26 Healthcare Business Monthly with meniscus repair (medial AND lateral) Meniscectomy (29880, 29881) and meniscal repairs (29882, 29883) may be performed alone or with other services, and often are the primary service. Meniscectomy involves surgical removal of all or part of a torn meniscus, while and are used when the meniscal tear is repairable. A key concept in reporting meniscectomy and meniscal repair is that of knee compartments. CPT, AAOS, and Medicare all recognize three anatomic compartments in the knee (medial, lateral, and patellofemoral). CPT definitions, GSD guidelines, and NCCI guidelines are based on whether meniscal or other procedures are performed in one or multiple compartments. In some cases, a second procedure may be reported if performed in a separate compartment; whereas, if Coding/Billing Auditing/Compliance Practice Management image by istockphoto pelicankate

27 Knees performed in the same compartment as the primary procedure, it s not separately reportable. By definition, reports meniscectomy in both the medial and lateral compartments, while defines a meniscectomy in either the medial or lateral compartment. Since 2012, codes and have included debridement/shaving of articular cartilage (chondroplasty), whether it s performed in the same or a separate compartment. The meniscal repair codes also designate options for both medial and lateral compartments (29883) or for only one compartment (29882). Modifiers 59 and X {EPSU} Primer As defined by CPT, the criteria to use modifier 59 Distinct procedural service are: Different session; Different procedure or surgery; Different site or organ system; Separate incision/excision; Separate lesion; or Since 2012, codes and have included debridement/shaving of articular cartilage (chondroplasty), whether it s performed in the same or a separate compartment. Separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. When CPT guidelines support reporting both services, modifier 59 may be appropriate to show requirements have been met. CMS recognizes modifier 59 for Medicare claims, but has instructed providers to only use modifier 59 when there is an NCCI procedure-to-procedure edit between two codes, and only when no other more specific modifier can be used. For a detailed review of how CMS interprets modifier 59, refer to the NCCI guidelines, chapter I, section E. Based on these guidelines, physicians may be able to use the modifier for non-medicare payers when they may not use it for Medicare claims. In 2015, CPT and CMS introduced the X {EPSU} modifiers, which can be used to describe specific circumstances where codes are reported together due to separate encounter (XE), separate provider (XP), separate structure (XS), and unusual non-overlapping service (XU) factors. Because the knee is a single structure, it s not appropriate to use modifier XS with a second procedure in the ipsilateral knee. The concept of anatomic compartments in the knee, described elsewhere, do not qualify as separate structures. These modifiers are not used with another, more appropriate modifier (e.g., modifier 59) The meniscal repair code definitions do not include chondroplasty, which may be separately reported when performed in a separate compartment. Chondroplasty Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) Under CPT rules, arthroscopic chondroplasty in the medial, lateral, and/or patellofemoral compartment(s) may be reported once per surgical session with other arthroscopic procedures when performed in a separate compartment excluding meniscectomy procedures and As such, report chondroplasty only when it s the sole procedure performed in the separate compartment. Likewise, the GSD guidelines state is separately reportable with other procedures when performed in a separate compartment where no other surgical procedure is performed, and when it s not included in the primary code by definition (29880 and do not meet this requirement). Based on CPT and GSD guidelines, you may append modifier 59 to indicate chondroplasty was performed as the only procedure in a separate compartment (except as previously noted). Medicare rules are different for chondroplasty reporting. Since 2003, Medicare has instructed providers to use HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chrondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee*, instead of 29877, to report chondroplasty when it s performed in a separate compartment. G0289 was created for reporting on Medicare claims. It was not intended for use by non-medicare payers, although some non-medicare payers have adopted it. Although a 0 NCCI edit pairs and the meniscal repair codes, this does not mean chondroplasty is not reportable with meniscal repairs to CMS or any other payer. Instead, you re instructed to use G0289 for Part B Medicare beneficiaries to report the service if the separate compartment criterion is met and no additional surgery is performed in that compartment. *Chapter IV of the NCCI guidelines modifies the descriptor of G0289 slightly, as Surgical knee arthroscopy for removal of loose body, foreign body, debridement/shaving of articular cartilage at the time of other surgical knee arthroscopy in a different compartment of the same knee. CODING/BILLING February

28 Knees CODING/BILLING Warning! Do not use either or G0289 to report chondroplasty with meniscectomy or because the chondroplasty is inclusive to their definitions. Because G0289 s definition says at the time of other surgical knee arthroscopy, if chondroplasty is the only procedure performed, is the appropriate code for all payers, including Medicare. Warning! Do not use either or G0289 to report chondroplasty with meniscectomy or because the chondroplasty is inclusive to their definitions. Chondroplasty, whether reported as or G0289, may be separately reported with meniscal repair codes and 29883, when performed in a separate compartment, assuming another reportable service is not performed there. Keep in mind Medicare has directed us to only use modifier 59 when a procedure-to-procedure edit exists between two codes (see sidebar Modifiers 59 and X {EPSU} Primer). There is no procedure-to-procedure edit between or and G0289. It s not correct to apply modifier 59 to Medicare claims with these codes. Medicare assumes that G0289 represents the arthroscopic removal of a loose body or foreign body in a different compartment. Modifier 59 may be applied when reporting to private payers to indicate the separate compartment rule is met. Removal of Loose or Foreign Bodies Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation) As is true when reporting chondroplasty, there are differences between CPT and Medicare reporting requirements when reporting arthroscopic removal of loose or foreign bodies. Although the CPT definition does not specify as such, the GSD guidelines clarify that reporting removal of loose or foreign bodies through the arthroscopic sheath is included in the base procedure and that removal of loose or foreign bodies greater than 5 mm and/or through a separate incision is separately reportable. Under these criteria, for a non-medicare patient, a physician could report loose or foreign body removal using with a primary service such as meniscectomy or meniscal repair (even from within the same compartment), and you would use modifier 59 to indicate the size or separate incision criteria are met. For Medicare patients because G0289 includes the reference in a different compartment of the same knee do not report loose or foreign body removal performed in the same compartment as another procedure, even if the size and incision criteria are met. Report for a Medicare patient only when it s the sole procedure performed. Medicare reinforces its definition of G0289 though an NCCI guideline in chapter IV: HCPCS code G0289 should not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. Report G0289 only if the separate compartment requirement is met in addition to the size or incision expectation. Table 1 compares the reporting methods for meniscectomy and meniscal repairs with chondroplasty and loose/foreign body removal, separating CPT and Medicare rules Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Limited synovectomy is defined in CPT as a separate procedure. As such, do not report with another arthroscopic procedure in the same knee. Report it when it s the only arthroscopic procedure Table 1 Primary procedure Chondroplasty in separate compartment Chondroplasty in separate compartment Loose body if separate incision and/or size criteria are met, no chondroplasty in same compartment Loose body if separate incision and/or size criteria are met not separate compartment Guideline Set CPT /GSD Medicare CPT /GSD Medicare Medicare Not reportable Not reportable Not reportable G Not reportable Not reportable Not reportable G G Not reportable G G Not reportable G0289 Loose body in separate compartment, no other arthroscopic procedure 28 Healthcare Business Monthly

29 To discuss this article or topic, go to Knees image by istockphoto Bunyos NCCI edits pair with and with a 0 modifier indicator because Medicare requires G0289 to describe either the chondroplasty or loose/foreign body removal when performed with 29873, and to meet the separate compartment criterion. According to CPT, as long as pathologic synovial disease is present, you may consider with another arthroscopic knee procedure, even if it occurs in the same compartment excluding procedures for removal of loose/foreign body or chondroplasty. Medicare applies a second requirement through an NCCI guideline in Chapter IV. In addition to requiring medical necessity of pathologic synovial disease, is reported only if no other arthroscopic surgery is performed in the same compartment. CODING/BILLING Lateral/Retinacular Release Arthroscopy, knee, surgical; with lateral release NCCI edits pair with and with a 0 modifier indicator because Medicare requires G0289 to describe either the chondroplasty or loose/foreign body removal when performed with 29873, and to meet the separate compartment criterion. Under CPT rules, chondroplasty must be performed in a separate compartment to report performed on that knee. Compartments are not recognized for the purpose of reporting this CPT code Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) Major synovectomy involves resection of pathologic synovial disease from two or more knee compartments. To report 29876, it s not enough for the surgeon to simply clean up the joint while performing more extensive surgery. Rather, per Coding Knee Arthroscopies by Mary LeGrand (AAOS Now, January 2013), To report both procedures, the surgeon should document the medical necessity and the performance of a synovial resection for pathology not just cleaning up loose synovium that might be fibrillating in the joint. The same article provides detailed examples on this topic. In other words, to report major synovectomy in addition to another arthroscopic knee procedure, documentation must establish pathologic synovial disease. Reporting of this service varies based on CPT and Medicare rules: Lysis of Adhesions Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) Because it s a separate procedure, do not report arthroscopic lysis of adhesions with any other arthroscopic procedure in the same knee, whether for Medicare or non-medicare claims. Sarah Wiskerchen, MBA, CPC, is a senior practice management consultant with Chicagobased KarenZupko & Associates. She specializes in CPT and ICD-10 orthopaedic coding education, reimbursement analysis, and process consulting. Wiskerchen works with orthopaedic; ear, nose, and throat; and neurosurgery practices nationally. She is a member of the Oakbrook, Ill., local chapter. February

30 Chat Room Facebook Post Spreads Member Support If you post on AAPC s Facebook page, many AAPC employees read your threads. Lately, our staff has really felt the love from members. You have been surprising us with kind words about our organization and fellow members. On December 31, 2015, we were thrilled to read this heartfelt post by Denise Rolfs, CPC-A, from Massachusetts: CHAT ROOM Our coding courses with AAPC CEUs: The Where s and When s of ICD-10 (16 CEUs) Dive Into ICD-10 (18 CEUs) E/M from A to Z (18 CEUs) Primary Care Primer (18 CEUs) E/M Chart Auditing & Coding (16 CEUs) Demystifying the Modifiers (16 CEUs) Medical Coding Strategies: CPT O view (15 C s) Walking Through the ASC Codes (15 CEUs) Coding with Heart Cardiology (12 CEUs) HealthcareBusinessOffice LLC: Toll free info@healthcarebusinessoffice.com Web site: 30 Healthcare Business Monthly Be with the family and earn CEUs! Need CEUs to renew your CPC? Stay in town. At home. Use our CD courses anywhere, any time, any place. You won t have to travel, and you can even work at home. HBO-AD From the leading provider of computer-based interactive CD courses with preapproved CEUs Take it at your own speed, quickly or leisurely Just 1 course can earn as many as 18.0 CEUs Apple Mac support with our Cloud-CD option Windows support with CD-ROM or Cloud-CD Cloud-CD lower cost, immediate Web access Add l user licenses great value for groups Finish a CD in a couple of sittings, or take it a chapter a day you choose. So visit our Web site to learn more about CEUs, the convenient way! (All courses with AAPC CEUs also earn CEUs with AHIMA. See our Web site.) Check out our website for our newest course, The Where s and When s of ICD-10! Continuing education. Any time. Any place.

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32 CODING/BILLING By Colleen Gianatasio, CPC, CPC-P, CPMA, CPC-I Make the Most of HCCs Part 2: Explore more commonly under-coded conditions and bolster documentation. image by istockphoto tetmc Accuracy and specificity in diagnosis coding and medical documentation are critical in risk adjustment models. This second installment of our three-part series examines additional commonly under-coded conditions included in the Medicare hierarchical condition category (HCC) risk adjustment model, and discusses documentation strategies for improving diagnosis coding. Major Depressive Disorder, Bipolar, and Paranoid Disorders HCC 57 Depression is a serious disorder affecting both the mind and body. Left untreated, the condition often becomes more severe and can damage all areas of a person s life. Doctors employ a variety of methods to diagnose depression, including a physical exam, lab tests, and psychological evaluations. Mental health providers use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose mental health conditions. Bipolar and manic disorders also are included in this category. These disorders are characterized by mood swings that can go from 32 Healthcare Business Monthly very high to very low. Conditions of this nature are usually treated with medication and counseling. ICD-10 provides an increase in coding specificity within this category (as it does on a whole compared to ICD-9). The added volume of codes that are risk adjusted in the new code set is substantial. Physician documentation should state whether the episode is single or recurrent, the severity, with or without psychotic features, and remission status (partial or full). New concepts in ICD-10 include depressive reaction, psychogenic depression, and reactive depression. Codes now require more specificity for intentional self-harm and suicide attempts. Rheumatoid Arthritis and Inflammatory Connective Tissue Disease HCC 40 Rheumatoid arthritis (RA) is an autoimmune disorder that occurs when the immune system mistakenly attacks its host. Considered a chronic inflammatory disorder, RA affects the lining of the joints, which causes painful swelling. The disease can affect other organs of the body, as well, including the skin, eyes, lungs, and blood vessels. Coding/Billing Auditing/Compliance Practice Management

33 To discuss this article or topic, go to HCCs Signs and symptoms of RA include tender, warm, swollen joints, morning stiffness, firm tissue bumps under the skin of the arms, fatigue, fever, and weight loss. RA increases the risk of developing other diseases, such as osteoporosis, carpal tunnel syndrome, heart problems, and lung disease. There is no known cure for RA; treatment focuses on controlling symptoms and preventing joint damage. According to current American College of Rheumatology guidelines and clinical practice standards, patients with RA require initiation of disease-modifying anti-rheumatic drug (DMARD) therapy within three months of diagnosis. RA can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no single blood test or physical finding to confirm the diagnosis. A diagnosis is made by physical exam, blood tests, and X-rays. For documentation and coding purposes, it s important to avoid the common pitfall of using a rule out diagnosis code. Do not use an RA code until a definitive diagnosis is made. Code the patient s symptoms, such as pain in joints, until the diagnosis is confirmed. Other common diagnoses in this category include polymyalgia rheumatic and sicca syndrome (Sjögren s syndrome). This category has more codes to choose from in ICD-10 than it had in ICD-9. This is due to the introduction of several new concepts: laterality, with or without organ or system involvement, and with or without rheumatoid factor. Specified Heart Arrhythmias HCC 96 An arrhythmia is an abnormal heart rhythm that occurs when the electrical impulses in the heart don t function correctly. This causes the heart to beat too fast (tachycardia), too slow (bradycardia), or erratically. Symptoms include palpitations, fluttering dizziness, shortness of breath, and fatigue. It s not uncommon for a patient to be asymptomatic and to have the arrhythmia revealed only through a physical exam. Arrhythmias can be caused by a number of different factors, such as: Scarring of heart tissue from a prior heart attack Coronary artery disease High blood pressure There is great opportunity for outpatient coders to have a very positive affect in their practice, as well as in our industry. Diabetes Hyperthyroidism Hypothyroidism Smoking Drinking too much alcohol or caffeine Drug abuse Stress Certain prescription medications Electrical shock or air pollution Treatment includes antiarrhythmic medications, anticoagulant or antiplatelet therapy, cardioversion, ablation therapy, a pacemaker, an implantable cardioverter-defibrillator, and/or the Maze procedure. It s common for a patient with a heart arrhythmia to be stable because of medication treatment. In these cases, it s important for the provider s documentation to provide a link from the medication to the specific condition it s being used to treat. New concepts in ICD-10-CM include re-entry ventricular arrhythmia and junctional premature depolarization. Another notable change is that sick sinus syndrome now has its own distinct code (I49.5 Sick sinus syndrome). In ICD-9-CM, sick sinus syndrome fell under the larger category of sinoatrial node dysfunction ( Sinoatrial node dysfunction). Sinoatrial node dysfunction includes a number of conditions that cause inappropriate atrial rates. Sick sinus syndrome refers to a type of bradycardia where the sinoatrial node does not function properly. These are just a few of the categories in the Medicare HCC model. There is great opportunity for outpatient coders to have a very positive affect in their practice, as well as in our industry. Focusing on a few, simple documentation improvement strategies at a time will help to illustrate patients true severity of illness. Correctly documenting and coding diagnoses will ensure better patient care, as patients are more easily identified for care management by Medicare and other payers. This data ultimately serves to provide the industry with financial forecasting and planning, which drives care cost. Colleen Gianatasio CPC, CPC-P, CPMA, CPC-I, is a risk coding and education specialist for Capital District Physician s Health Plan. She enjoys teaching PMCC, auditing, and ICD-10 classes. Gianatasio is president of the Albany, N.Y., local chapter and a member of the National Advisory Board. CODING/BILLING February

34 Lorem ipsum dolor sit amet, congues. ALPHABET SOUP Become Familiar with Clinical Lingo Learning medical terminology is like learning a foreign language. If you can t speak the language, you might as well pack your bags. To talk like the natives, learn these common medical terms and acronyms: A&P ABG AKA bid BK BMI CABG CBC Cholecystitis DRG DTR Dx EBL ECG or EKG ETOH FBS FBW FIFO Anatomy and physiology Arterial blood gas Above the knee Twice a day Below the knee Body mass index Coronary artery bypass graft Complete blood count Inflammation of the gallbladder Diagnosis-related group Deep tendon reflexes Diagnosis Estimated blood loss Electrocardiogram Ethyl alcohol, intoxicated Fasting blood sugar Fasting blood work First in, first out image by istockphoto levoncigol Subscribe to BC Advantage Magazine today! BC ADVANTAGE May / June 2015 Issue 10.3 The Essential Resource for Medical Office Professionals Aug/Sept 2014 Issue 9.5 LOW-COST educational resources for Medical Office Professionals ADVANTAGE PQRS Gets More Complicated as 48 Measures are Retired Are Practices Ready for Cyber Attacks? Relative Value Units: Important Now More Than Ever Social Media: A Tool for ICD-10 Transition? How to Identify Who Sent Your Healthcare EFT Payment Is Your Employee Manual Up to Date?? Happy The Patients Face Who of Pay Your More Practice Bills Great Customer Service Preventative The Face vs. of Diagnostic Your Practice Services Great Customer Service DELIVER RESULTS EFFECTIVELY FOR BILLING COMPANIES, PROVIDERS, AND SUPPLIERS HOW TO EDUCATE PROVIDERS IMPORTANT NEW CONCERNS USEFUL LAYOUTS 12 ICD-11 WORTH THE WAIT? THIS COULD BE THE BEST LIMITED TIME OFFER Receive 16 CEUs and 12 Webinars FREE with your LOW-COST MAGAZINE subscription today! medical coders Billing Coding DEAL EVER! FREE CEUS FREE WEBINARS FREE ICD-10 RESOURCES To find out more visit 34 Healthcare Business Monthly

35 Best Online Code Lookup Tool! Online Coding Made Easy: Lay Descriptions CPT Crosswalks ICD-10 Bridges Fee Schedules NCDs & RVUs Survival Guides Real Time Claim Scrubber CPT Modifiers ICD-9 Crosswalks CCI Edits Checker Medicare LCD lookup CMS Transmittals Specialty Newsletters AAPC Coder EARN UP TO 20 CEUs WITH YOUR ANNUAL SUBSCRIPTION I find the CMS 1500 claim edit checker to be the most helpful tool ever created by coding-mankind. I also love the fact that everything is in one place: LCD, NCCI edits, Fee Schedule, etc. Vanessa M. Start Your FREE Trial Today! Visit aapc.com/coder today or call February

36 CODING/BILLING By Andrew H. Selesnick and Stacey L. Zill Don t Lose Sleep Over Medicare Billing Intricacies of Sleep Apnea Treatment image by istockphoto OcusFocus Before reporting treatment, make sure oral appliances are reasonable and necessary, and check carrier policies. 36 Healthcare Business Monthly Coding/Billing Auditing/Compliance Practice Management

37 Sleep Apnea Obstructive sleep apnea (OSA) affects 18 million Americans, according to the National Sleep Foundation. OSA occurs when breathing is interrupted briefly and repeatedly during sleep. There are circumstances under which Medicare will cover oral appliances used for the treatment of OSA using billing code E0486 Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment. To ensure correct billing of OSA services, let s review procedural documentation requirements.* *This analysis applies specifically to jurisdictions including New York, Connecticut, District of Columbia, Delaware, Massachusetts, Maryland, Maine, New Hampshire, New Jersey, Pennsylvania, Rhode Island, and Vermont. For coverage in other jurisdictions, refer to the appointed Medicare administrative contractor s guidance. For an item to be covered by Medicare, a detailed written order (DWO) must first be received by the supplier (i.e., the dentist) before a claim is submitted. Oral appliances are used to reposition oral and pharyngeal tissues to create and maintain a patient s airway during sleep. Mandibular advancement devices reposition the mandible in a forward position. A custom fabricated mandibular advancement oral appliance (E0486) used to treat OSA is covered under Medicare if: A. The patient has a face-to-face clinical evaluation by the treating physician prior to the sleep test to assess the beneficiary for OSA testing. B. The beneficiary has a Medicare-covered sleep test that meets one of the following criteria (1-3): 1. The apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) is greater than or equal to 15 events per hour, with a minimum of 30 events; or CODING/BILLING image by istockphoto robroxton Medicare Coverage for Oral Appliances in OSA Treatment Medicare has endorsed oral appliances as an accepted treatment for OSA (Check with commercial carriers for local coverage determinations.). Specifically, oral appliances used to treat OSA are covered under the Durable Medical Equipment (DME) benefit, as provided for in Social Security Act 1861(s)(6). For a patient s equipment to be eligible for Medicare reimbursement, reasonable and necessary requirements must be met in accordance with Social Security Act 1862(a)(1)(A), as must specific statutory payment policy requirements. For any DME to be covered by Medicare, it must: (a) Be eligible for a defined Medicare benefit category; (b) Be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member; and (c) Meet all other applicable Medicare statutory and regulatory requirements. Medicare also requires a detailed written order (DWO) to be received by the DME supplier (e.g., the dentist) before a claim is submitted. The item will be denied as not reasonable and necessary if it lacks a DWO. 2. The AHI or RDI is greater than or equal to five and less than or equal to 14 events per hour, with a minimum of 10 events and documentation of: a. Excessive daytime sleepiness, impaired cognition, mood disorders, or insomnia; or b. Hypertension, ischemic heart disease, or history of stroke; or February

38 Sleep Apnea To be covered by Medicare, the oral appliance must be classified as DME rather than as a dental device. CODING/BILLING 3. If the AHI is greater than 30, or the RDI is greater than 30, and meets either of the following: a. The beneficiary is not able to tolerate a positive airway pressure (PAP) device; or b. The treating physician determines the use of a PAP device is contraindicated. C. The treating physician orders the device following a review of the report of the sleep test. (The physician who provides the order for the oral appliance could be different from the one who performed the clinical evaluation in criterion A.) D. The device is provided and billed for by a licensed dentist (doctor of dental surgery or doctor of dental medicine). If all of these criteria (A-D) are not met, the custom fabricated oral appliance (E0486) will be denied as not reasonable and necessary. Statutory Payment Policy Requirements Coverage for an oral appliance for the treatment of OSA is limited to claims where the diagnosis of OSA is based on a Medicare-covered sleep test. A Medicare-covered sleep test must be either a polysomnogram performed in a facility-based laboratory (type I study) or a home sleep test (types II, III, IV, or other home sleep studies). The patient s treating physician must order the test and it must be conducted by an entity qualifying as a Medicare provider of sleep tests in compliance with all applicable state regulatory requirements. To be covered by Medicare, the oral appliance must be classified as DME rather than as a dental device. The following items (not allinclusive) are considered to be dental devices and will be denied as non-covered, not DME: Oral occlusal appliances used to treat temporomandibular joint (TMJ) disorders; Tongue retaining devices used to treat OSA and/or snoring; All oral appliances used only to treat snoring without a diagnosis of OSA; Oral appliances used to treat other dental conditions; and Oral appliances that require repeated fitting and/or adjustments, beyond the first 90 days, to maintain fit and/or effectiveness. A custom fabricated oral appliance (E0486) (i.e., one that may be classified as DME) is uniquely made for the patient. It involves taking an impression of the patient s teeth and making a positive model of plaster or equivalent material. Basic materials are cut, bent, and molded using the positive model. It requires more than trimming, bending, or making other modifications to a substantially prefabricated item. A custom fabricated oral appliance may include a prefabricated component (e.g., the joint mechanism). Code E0486 may be used for custom fabricated mandibular advancement devices. To be coded as E0486, custom fabricated mandibular advancement devices must meet all of the following criteria: Have a fixed mechanical hinge at the sides, front, or palate; image by istockphoto designer Healthcare Business Monthly

39 To discuss this article or topic, go to Sleep Apnea The purpose of the application is to obtain approval that the DME falls within the applicable coding guidelines for payment under E0486. Require no return dental visits beyond the initial 90- day fitting and adjustment period to perform ongoing modification and adjustments to maintain effectiveness. CODING/BILLING Registering the Oral Appliance and Billing Medicare Before billing Medicare, the manufacturer (the person or entity actually making the oral appliance) and/or the distributor such as the medical group billing or the dentist ordering and providing the oral appliance for the patient (the person or entity with the DME provider number) must submit an application with the Medicare Pricing, Data Analysis and Coding (PDAC) division of Noridian Healthcare Solutions, LLC. (Noridian), or with your local Medicare contractor. The purpose of the application is to obtain approval that the DME falls within the applicable coding guidelines for payment under E0486. The oral appliance manufacturer or distributor (with a sign off by the manufacturer) must submit the application with PDAC. This document and instructions are available on Noridian s website (PDAC will help negotiate through the process and will answer any questions). Unless the manufacturer/distributor and DME are registered on the PDAC website, the oral appliance will not be paid by Medicare. According to Noridian/PDAC, this application process can take as long as 90 days. After the DME provider number is obtained (through the national supplier clearinghouse, Palmetto GBA), and a Medicare-approved appliance is used (i.e., one listed on the PDAC website), the DME provider (i.e., the medical group or dentist) can bill for the oral appliance for the treatment of OSA. Be able to protrude the individual patient s mandible beyond the front teeth when adjusted to maximum protrusion; Incorporate a mechanism that allows the mandible to be advanced easily by the patient in increments of one millimeter or less; Retain the adjustment setting when removed from the mouth; Maintain the adjusted mouth position during sleep; Remain fixed in place during sleep to prevent dislodging the device; and Resources: Noridian Healthcare Solutions, LLC; PDAC: Palmetto GBA: Stacey Zill and Andrew Selesnick are partners in the Law Firm of Michelman & Robinson, LLP (M&R). M&R has offices in California and New York. Selesnick and Zill can be reached at aselesnick@mrllp.com or szill@mrllp.com. February

40 CODING/BILLING By Karla M. Hurraw, CPC, CCS-P Move Over 2015 Vaccine Coding Make room for CPT 2016 updates. image by istockphoto lovelyday12 Over a dozen of the 60 changes affecting vaccines in CPT 2016 consist of deleting outdated, unused codes (e.g., Japanese encephalitis virus vaccine, for subcutaneous use was deleted). Nearly four dozen other changes involve descriptor revisions, typically without altering code use (e.g., the acronym for varicella virus vaccine (VAR) was added to the descriptor of Varicella virus vaccine (VAR), live, for subcutaneous use). There are also four new vaccine codes: Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB), 2 dose schedule, for intramuscular use Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB), 3 dose schedule, for intramuscular use Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use 40 Healthcare Business Monthly The MenB vaccinations are newly available vaccinations developed to target another serogroup of meningitis; they do not replace the current meningococcal vaccinations. According to the World Health Organization, the cholera vaccination is not available in the United States, but it is being used in other countries where cholera is more prevalent. Vaccine Administration Vaccine administration codes are unchanged in Codes Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered and Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (List separately in addition to code for primary pro- Coding/Billing Auditing/Compliance Practice Management

41 Vaccine Coding cedure) describe vaccination administration for patients age 18 years or younger when the provider counsels (and documents) the patient and/or guardian on the risks, benefits, and potential side effects of the vaccination. The codes are reported based on the number of components in each vaccine. Code is billed for the first component of each vaccination, and is billed for each additional component (with as many units reported, as applicable). For example, Tdap has three components: tetanus, diptheria, and pertusis. This is billed x 1, x 2. If Tdap and a flu shot are both given, report x 2 (one unit for the first component of Tdap, and one unit for the flu shot) and x 2 (for the additional two components of Tdap). For patients 18 years and under, when no counseling is given, or for anyone over 18, vaccinations are billed using the following: Remember: Medicare specifies its own administration codes. CODING/BILLING Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/ toxoid) each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) These codes are billed per vaccination, with either or (according to the route of administration) for the first vaccine and or for each additional vaccination. Codes and describe intramuscular (IM) or subcutaneous injections; and report oral or intranasal. Note that either or can be billed for the first vaccination; if you administer one IM vaccine and one oral vaccine, you may report either and or and Remember: Medicare specifies its own administration codes. G0008 Administration of influenza virus vaccine is for administration of a flu vaccination, G0009 Administration of pneumococcal vaccine is for a pneumonia vaccination, and G0010 Administration of hepatitis b vaccine is for a hepatitis B vaccination. Administration code Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular is to be used for therapeutic injections, not vaccinations but as with all coding, check with the payer for their specific guidelines regarding vaccination administration billing. image by istockphoto FrankRamspott Karla Hurraw, CPC, CCS-P, is the billing office team lead for DeKalb Health Medical Group at DeKalb Hospital in Auburn, Ind. She is a member of the Fort Wayne, Ind., local chapter. February

42 CODER S VOICE By Suzan (Berman) Hauptman, MPM, CPC, CEMC, CEDC Get the Message to Your Clinicians image by istockphoto GeorgeRudy Work together to achieve mutual admiration and respect. People become physicians to take care of patients. Coders are tasked to help physicians identify the services they render for accurate reimbursement. Coders and physicians need each other, and can work together successfully when they have the right tools and the right attitude. Gather Tools and Adjust Your Attitude The tools, you have: certification, encoder, books, resources, AAPC listservs, and all of your contacts. You need each of these tools to gain information and keep current, and to become a respected and well-informed coder, manager, auditor, compliance officer, etc. The other piece is attitude. To be more precise, there needs to be mutual admiration and respect within the coder/physician relationship. To cultivate a relationship that will benefit both parties equally, ask yourself: How do I achieve mutual respect and a beneficial relationship? 42 Healthcare Business Monthly

43 Get the Message Your ability to provide information to enhance (rather than to hinder) the physician s day-to-day activity is where your value will be appreciated. How can I teach the physician? What can the physician teach me? Begin by scheduling a meeting with the physician to discuss his or her goals for you, and how the two of you can work together toward those goals. Step into Each Other s Shoes While you re at it, ask if it s possible to shadow your physician in the office or hospital to get a sense of a day in the life. This will help establish a dialogue and a professional relationship in an environment the physician is used to. The physician will show you what he or she does, and may ask you how his or her actions affect coding. It s important for the physician to see you re there to help make things easier, rather than to add to an already over-booked day. Review the notes from your shadowed visits and share with your physician what you ve learned from the documentation. This will give the physician an opportunity to improve his or her documentation process, if needed. The physician may have additional questions, ask you to review more notes, and/or want more coding advice for other services he or she provides. Here is where your relationship will blossom. Your ability to provide information to enhance (rather than hinder) the physician s day-to-day activities is where your value will be appreciated. If you can help to make the documentation and coding process easier and more efficient, the physician will find that invaluable. Learn Through Example Let s say, for example, that during the time you shadowed the physician, you noticed the medical assistant (MA) wrote everything he did on scratch paper that the physician then had to enter into the electronic health record. This information could be entered directly into the EHR by the MA, and then the physician would need only review it. By reducing the time the physician spends documenting, you just increased his or her productivity. In another example, perhaps the physician you shadowed was clearly frustrated with the time it took to track down a nurse to order additional tests for a patient. Imagine the physician s jubilation when you tell her there s a form she can use to indicate what tests she should order when the patient checks out. While shadowing your physician, you may also notice discrepancies that could lead to improper payments. For example, you notice the physician putting in an order for an MA to administer an injection. The drug is sent out on the claim, but the administration isn t. Having witnessed the service being performed, you help the office determine how the injection administration can also be billed when ordered and administered appropriately. Be Valuable and Exude Confidence Examples such as these help to foster a relationship with the physician and prove you are a valuable part of the team. In turn, you ll have the confidence to approach the physician, when necessary. You ll also know that the information you provided is being incorporated daily and used regularly. Or at least you ve made that first contact so the next contact will be well received and appreciated. If shadowing isn t an option (for instance, maybe you are offsite), you may want to arrange for a virtual conversation with the physician to hear his or her concerns. A good way to start the conversation is to ask the physician about a typical day and see where that takes you. Try this approach with your physicians. They ll appreciate your willingness to learn about their day-to-day regiment and you ll take away a wealth of information and a newfound friend. Suzan (Berman) Hauptman, MPM, CPC, CEMC, CEDC, is the senior principle with ACE Med, an auditing, coding, and education consulting firm bringing knowledge to both clinicians and coders. Hauptman is an alumni of the AAPC National Advisory Board and the AAPC Chapter Association board of directors. She is a current advisory board member for Optum, an editor for The Coding Institute, and a member of the Pittsburgh Central, Pa., local chapter. February

44 AUDITING/COMPLIANCE By Robert Pelaia, Esq., CPC, CPCO, and Jamie Ewing The Yates Memo provides a renewed focus on individual accountability in corporate misconduct. On September 9, 2015, Sally Q. Yates, the current deputy attorney general for the United States Department of Justice (DOJ), issued a guidance memorandum for prosecuting individuals involved in corporate misconduct, known as the Individual Accountability for Corporate Wrongdoing memorandum (Yates Memo). The Yates Memo notes that seeking individual accountability is a critical component in fighting corporate misconduct. The Yates Memo also emphasized that individual accountability is important because it: 1. Deters future illegal activity; 2. Incentivizes changes in corporate behavior; 3. Ensures the proper parties are held responsible for their actions; and 4. Promotes the public s confidence in the U.S. justice system. A corporation can only act through its individuals. Scaling Misconduct Down to an Individual Level Bringing charges against a corporation is different than bringing charges against the individuals in the corporation; a significant area of concern in large corporations is identifying the individuals involved in the misconduct. Staff hierarchy in corporations often leads to decisions being made at various levels in the company. It can create a hardship to pinpoint responsibility because it s difficult to determine which individuals had knowledge of which activities. The Yates Memo notes that high-level executives are often insulated from the day-to-day activities in which the misconduct occurs. 44 Healthcare Business Monthly Coding/Billing Auditing/Compliance Practice Management

45 Wrongdoing Working Group Starts Corporate Misconduct Initiative Due to the numerous challenges that exist when working to identify culpable individuals in corporate cases, the DOJ composed a working group to develop a new corporate misconduct initiative. This working group of senior attorneys from the DOJ and U.S. attorney community examined how the DOJ approaches corporate investigations and identified policies that needed amending to increase individual accountability for corporate wrongdoings. The Individual Accountability for Corporate Wrongdoing memorandum (Yates Memo) expands upon the DOJ s previous policy and incorporates new guidelines, particularly concerning cooperation from corporations. The new guidelines provided in the Yates Memo will be incorporated into the U.S. Attorneys Manual, and the new guidelines will apply to current, pending investigations and all future investigations. The Yates Memo also applies to civil corporate matters, as well as criminal matters. This insulation requires investigators to cull through an exorbitant number of documents to determine culpability at individual levels. To assist prosecutors with their investigations, the DOJ developed the concept of cooperation credit. When a corporation helps cooperate with the investigation by providing misconduct information to internal investigators and the DOJ, it s eligible for cooperation credit. This credit essentially shows good faith and can become a mitigating factor in the prosecution of the corporation, as a whole. Six Key Steps in Enforcement of Corporate Misconduct The Yates Memo highlights six key steps to reinforce pursuing individuals for corporate wrongdoing. 1. To be eligible for any cooperation credit, corporations must provide all relevant facts to the DOJ about the individuals involved in corporate misconduct. 2. Both criminal and civil corporate investigations should focus on individuals from the start of the investigation. 3. Criminal and civil attorneys handling corporate investigations should be in routine communication with one another throughout the investigation. 4. Absent extraordinary circumstances, no corporate resolution of the claim will provide individuals with protection from criminal or civil liability. 5. Before a corporate case is resolved, there should be a clear plan in place to resolve any related individual cases before the statute of limitations expires, and any cases where prosecution decided not to bring charges must be memorialized. 6. Civil attorneys should consider more than the individual s ability to pay when deciding whether or not to bring suit. Let s examine each step in more detail. Step 1: Corporations must provide all relevant facts to receive cooperation credit. The Yates Memo states that corporations will not be considered for cooperation credit under the U.S. Attorneys Manual if all relevant facts about individual misconduct are not completely disclosed to the DOJ. All individuals involved must be reported to the DOJ regardless of their position, status, or seniority in the company. If a corporation does not meet the threshold requirement for reporting all relevant facts to the DOJ, the corporation is not eligible for cooperation credit. The Yates Memo outlines factors that should be analyzed to determine the extent of the cooperation. These factors include the timeliness, diligence, and thoroughness of the cooperation. DOJ should also consider the speed of the internal investigation and the proactive nature of the cooperation. Note that prosecutors should not blindly accept the information provided by the company. Prosecutors should vigorously analyze and review the information provided by the company and compare the company s information to their own investigation to ensure all information is correct. Step 2: Focus on individuals from the start of the investigation. The Yates Memo stresses the importance of focusing on individuals from the start of a corporate misconduct investigation. Early emphasis on individuals allows prosecutors to maximize their ability to ferret out the full extent of corporate misconduct. The Yates Memo also explains that focusing on individuals can increase the likelihood that individuals with knowledge of the misconduct will provide information about the higher-level individuals involvement. It also improves the probability of bringing charges against culpable individuals, as well as against the corporation. Step 3: Maintain routine communication between criminal AUDITING/COMPLIANCE February

46 Wrong doing AUDITING/COMPLIANCE The Yates Memo highlights that timely communication between civil and criminal prosecutors permits consideration of the full range of government s potential remedies. and civil prosecutors. There should be regular communication between civil and criminal prosecutors in corporate investigations. The Yates Memo highlights that timely communication between civil and criminal prosecutors permits consideration of the full range of government s potential remedies. Remedies include incarceration, fines, penalties, damages, restitution, asset seizure, forfeiture, suspension, and disbarment. When criminal prosecutors are investigating misconduct and become aware of possible civil liability, they should promptly notify civil prosecutors and vice versa. Step 4: No corporate resolution should provide protection from liability for individuals. The Yates Memo notes it s important for the DOJ to preserve the ability to pursue individuals in instances where resolution is reached with a corporation prior to resolution with the responsible individuals. Absent extraordinary circumstances or prior approved policy such as the Antitrust Division s Corporate Leniency Policy, DOJ should not accept any corporate resolutions that provide individuals with protection from criminal or civil liability. The Yates Memo states that any extraordinary circumstances must be approved in writing by the U.S. attorney or assistant attorney general involved in the investigation. Step 5: Develop a clear plan to resolve cases against individuals before the statute of limitations expires. The Yates Memo emphasizes that, in instances where authorization to resolve the case against the corporation is sought prior to concluding investigation against the individual, it s crucial for information about all potentially liable individuals to be memorialized. This information should include the status of the investigation and outline a specific action plan to promptly resolve the investigation before the statute of limitations runs out. If, at the investigation conclusion, the prosecution decides not to bring any civil or criminal charges against the individuals, it s imperative that the reasons for not bringing charges are memorialized and approved by the U.S. attorney or assistant attorney general involved in the investigation. Step 6: Civil attorneys should consider more than the individual s ability to pay when deciding whether or not to bring suit. The Yates Memo notes the DOJ has two key objectives in civil enforcement. First, the DOJ aims to recover as much money as possible. Second, the DOJ works to hold responsible individuals accountable and deter any misconduct in the future. In most circumstances these two objectives run parallel and do not conflict. There are certain circumstances where they are contrary to each other, however. The Yates Memo states that an example of this situation would be to determine if a civil action should be brought against individuals who do not have financial means to pay a judgment. The Yates Memo highlights that an individual s ability to pay should not be the decisive factor in determining whether to bring a civil suit. Certainly financial recovery is preferable, but in circumstances where an individual cannot pay, DOJ must weigh other factors, as outlined in the Yates Memo: 1. If the individual s misconduct is serious; 2. If the conduct is actionable; 3. If admissible evidence is sufficient to sustain a judgment; and 4. If pursuit of the action, there is an important federal interest. There is not a set monetary formula to apply when deciding whether or not to pursue a civil suit. Prosecutors much analyze each case image by istockphoto Milan Markovic 46 Healthcare Business Monthly

47 To discuss this article or topic, go to Wrongdoing image by istockphoto grapestock Healthcare corporations are under increased scrutiny and should implement new company policies to ensure individuals involved in misconduct are identified in a timely manner. on an individual basis. The Yates Memo notes that holding individuals accountable results in long-term deterrence. Differentiate the New Guidelines from the Old The Yates Memo has increased the threshold requirement for receiving cooperation credit by requiring corporations to identify all individuals involved in the misconduct regardless of their position, status, or seniority in the company. If information regarding identity of culpable individuals and facts relating to their misconduct is uncovered in the company s internal investigation, it must be reported to the DOJ for the company to be eligible to receive the cooperation credit. The Yates Memo places significant burdens on corporations in an attempt to encourage disclosure of facts in internal investigations. The increased emphasis on disclosure demonstrates the DOJ s increased vigor in pursuing each individual responsible for the misconduct in addition to the whole corporation. The Yates Memo emphasizes that the receipt of cooperation credit for all relevant fact disclosure is applicable in both criminal and civil contexts. The Yates Memo also encourages civil prosecutors to consider that individual accountability and deterrence is as important as financial recovery when deciding whether or not to bring suit. This shift to increased emphasis on civil penalties also highlights the DOJ s objective of encouraging corporate disclosure of all relevant facts. What It Means for Healthcare Corporations Healthcare corporations are under increased scrutiny and should implement new company policies to ensure individuals involved in misconduct are identified in a timely manner. High-level executives will no longer be able to rely on the company s protection to shield their individual liability. Although the company can work toward corporate resolution, the company cannot insulate high-ranking executive officers; all employees regardless of their status or seniority in the organization should demonstrate they were not involved in the misconduct by assisting the corporation s internal investigation. Employees can assist with the investigation by providing timely responses to inquiries and by acting in good faith with the company s internal investigation and the DOJ s investigation. Be sure your healthcare company is aware that, to receive cooperation credit, you must be willing to expose all individuals responsible in corporate misconduct. There is no blanket protection available for individuals involved in wrongdoing. As such, companies should consistently be on high alert to ensure all of their employees are complying with all state and federal rules and regulations at all times. Resources: DOJ of the Deputy Attorney General, Individual Accountability for Corporate Wrongdoing memorandum (Yates Memo): DOJ, Corporate Leniency Policy: Robert A. Pelaia, Esq., CPC, CPCO, is deputy general counsel at the University of South Florida in Tampa, Fla. He is certified as a Healthcare Law Specialist by the Florida Bar Board of Legal Specialization and Education, serves on AAPC s Legal Advisory Board, and was a AAPC National Advisory Board member. Pelaia is a member of the Tampa, Fla., local chapter. Jamie Ewing attends Florida Coastal School of Law, where she is now a full-time, third-year law student, Juris Doctor Candidate, May AUDITING/COMPLIANCE February

48 AUDITING/COMPLIANCE By Stacy Harper, JD, MHSA, CPC Comprehend Comprehensive Care for Joint Replacement Payment image by istockphoto coddy Manage costs and maximize quality related to the procedures paid under the new model. Effective April 1, 2016, acute care hospitals located in 67 geographic areas will be subject to a new payment model for lower extremity joint replacement (LEJR) services. Under the Comprehensive Care for Joint Replacement (CJR) payment model, the U.S. Department of Health & Human Services (HHS) will make participating hospitals accountable for the quality and cost of care related to LEJR. Hospitals Included in CJR All hospitals reimbursed under the Inpatient Prospective Payment System (IPPS) and located in one of 67 geographic areas selected by the Centers for Medicare & Medicaid Services (CMS) will be required to participate in the CJR payment model. The geographic areas are defined by a metropolitan service area (MSA) and include all hospitals within the boundaries of the MSA. A hospital s location is determined by the address associated with its CMS Certification Number (CCN). Hospital participation will include those within the MSA on April 1, 2016, and will not change if the MSA is adjusted during a performance period. Because the CJR payment model is mandatory for all IPPS hospitals within an MSA, Medicare patients receiving services from 48 Healthcare Business Monthly A list of the MSAs and affected hospitals selected for inclusion in the CJR payment model is available at A total of 789 hospitals were selected for participation in the CJR payment model. a CJR payment model-participating hospital must participate, as well. The CJR payment model will only apply to patients with original Medicare as their primary insurance beneficiaries enrolled in Medicare Advantage plans are excluded. Participating hospitals are required to provide specific notices to original Medicare patients to educate them regarding the model and certain beneficiary rights. Annual Reconciliation The CJR payment model will be tested for five performance periods between April 1, 2016, and December 31, The first performance period will run April 1, 2016, to December 31, 2016, and subsequent performance years will be based on the calendar year. During a performance year, the hospital and other providers will be Coding/Billing Auditing/Compliance Practice Management

49 Joint Replacement reimbursed for LEJR services under the usual Medicare fee-for-service payment systems. At the end of each performance year, CMS will calculate a reconciliation payment based on comparison of the total CJR target price and the actual episode payments. When the hospital obtains efficiencies and has episode payments below the total CJR target price, the hospital will be entitled to additional reconciliation payment, as long as quality measures are satisfied. Beginning in the second performance year, if a hospital s actual episode payments exceed the total CJR target price, the hospital will be responsible for repayment of the difference between the actual episode payments and the total CJR target price. The amount of potential repayment will be capped at a set percentage of the total CJR target price, with the percentage cap increasing each performance year. Definition of a LEJR Episode Payment For purposes of the CJR payment model, LEJR services are defined as hospital services reimbursed under the IPPS using either MS- DRG 469 (Major joint replacement or reattachment of lower extremity with major complications or comorbidities (MCC)) or MS-DRG 470 (Major joint replacement or reattachment of lower extremity without MCC). The LEJR episode for which a hospital is responsible begins with the Medicare patient s admission for a service that s assigned to MS-DRG 469 or 470 under IPPS, and continues for 90 days postdischarge. The episode payment includes all services provided to the Medicare patient and reimbursed under Medicare Part A or Part B during this time period related to the LEJR procedure. The amount of potential repayment will be capped at a set percentage of the total CJR target price, with the percentage cap increasing each performance year. Episode payment determination may include payments for physician services, inpatient and outpatient hospital services, inpatient psychiatric facility services, long-term care hospital services, inpatient rehabilitation services, skilled nursing facility services, home health services, outpatient therapy services, clinical laboratory services, durable medical equipment, Part B drugs, and hospice services related to the LEJR. The episode payment will exclude services that report certain MS- DRG or ICD-10-CM codes as a principal diagnosis. This list of episode exclusions includes chronic conditions that generally are not affected by the LEJR procedure or post-surgical care (such as removal of the prostate) and acute clinical conditions not arising from existing episode-related chronic clinical conditions or complications of LEJR surgery (such as appendectomy). Determination of the CJR Target Price The total CJR target price will be a sum of the CJR target prices for each episode of LEJR services the hospital provides during the performance period. To account for changes in fee schedule and clinical risk factors, each hospital will have a set of established CJR target prices. Separate CJR target prices will be set based on whether the service is provided January 1 to September 30 or October 1 to December 31 of the performance year to adjust for changes in the Medicare fee schedules. The CJR target price will be risk-adjusted based on use of MS-DRG 469 or 470 and the patient s hip fracture status. Further, separate CJR target prices will be set based on whether the hospital successfully reports the voluntary patient-reported outcome measure. The rates for each CJR target price will be determined based on three years of historical Medicare payment data, updated every two years. The historical data will be a blending of individual hospital data with regional data. Quality Measures If at the end of a performance year a hospital s episode payment is less than the total CJR target price, the hospital is entitled to a reconciliation payment, adjusted based on the quality category to which the hospital is assigned for that performance year. Hospitals participating in the CJR payment model will be assigned a composite quality score based on quality performance and improvement on the total hip arthroplasty (THA)/total knee arthroplasty (TKA) complications measure (NQF #1550) and the Hospital Consumer Assessment of Healthcare Providers and Systems survey measure (NQF #0116), as well as submission of THA/TKA voluntary patient reported outcomes and limited risk variable data. The composite quality score will then be used to place the hospital in one of four quality categories for each performance year, below acceptable, acceptable, good, and excellent. Hospitals in higher quality categories will be entitled to a greater percentage of reconciliation payment. AUDITING/COMPLIANCE February

50 Joint Replacement To discuss this article or topic, go to AUDITING/COMPLIANCE Fraud and Abuse Waivers In implementing the CJR, HHS recognized that hospitals may be able to achieve greater efficiency and quality through collaboration with other entities who participate in the provision of care during an LEJR episode. HHS, provides waivers of certain fraud and abuse requirements to participating hospitals so they can make financial arrangements with collaborating providers to share reconciliation payment risk. Like any fraud and abuse exception or safe harbor, the CJR waivers include specific requirements that must be satisfied for the collaboration arrangement to qualify. These requirements may include: Executing collaboration agreements prior to the provision of services; Developing hospital policies and procedures related to the collaboration; Establishing methodology to divide the gainsharing payments, which must include quality criteria and cannot be based on the volume or value of referrals; and Publicly notifying on the hospital s website of all entities with whom the hospital collaborates. HHS also provides limited waivers to the hospitals: To incentivize patients to adhere to a drug regimen or care plan, reduce readmissions and complications, or manage chronic diseases that could be affected by a LEJR procedure; To allow home health services without satisfying incident-to requirements; To create new G codes to report telehealth services provided related to the CJR payment model; and To waive the three-day hospitalization requirement for a patient to qualify for skilled nursing services in certain facilities. Hospitals that provide LEJR services to Medicare patients and are located in one of the 67 geographic areas selected for participation in the CJR payment model should assess their ability to manage costs and maximize quality related to these procedures. Collaboration agreements among providers should be carefully structured to satisfy fraud and abuse waiver requirements. Necessary preparations should be in place by April 1, Resources Stacy Harper, JD, MHSA, CPC, is a healthcare regulatory attorney with Lathrop & Gage LLP. She serves on AAPC s Legal Advisory Board and formerly served on the National Advisory Board. Harper regularly counsels healthcare providers related to complex billing and coding standards, Medicare participation and payment requirements, Stark Law, Anti-kickback Statute, HIPAA, and other state and federal healthcare laws. She is a member of the Kansas City, Mo., local chapter. image by istockphoto yezry 50 Healthcare Business Monthly

51 All-in-one Compliance For All Healthicity - 2 We reinvented compliance management through a complete, flexible solution that complies with all seven OIG recommendations to ensure you re compliant, even when audited. HEALTHICITY.COM/COMPLIANCEMANAGER February

52 AUDITING/COMPLIANCE By Frank Mesaros, MPA, MT (ASCP), CPC, CPCO Have Compliant Requisition Forms for Pain Management Drug Testing When providing toxicology drug testing, be sure requisition forms follow up-to-date guidance. Specimen source (if applicable) Date and time of specimen collection (if applicable) Last menstrual period for Pap smears and previous results Any additional information necessary to ensure accurate and timely testing and reporting The requisition form should reflect a conscious choice to order the tests, ensuring an independent medically necessary decision for each test the laboratory will bill. This entails having a place on the form to order panel tests individually including AMA-defined panels and custom panels. For example, an electrolyte panel (80051 Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)) is composed of four separate chemistry tests: Carbon dioxide (bicarbonate) Chloride; blood image by istockphoto Zerbor In August 1998, the Office of Inspector General (OIG) published the Compliance Program Guidance for Clinical Laboratories. Among other recommendations, these guidelines stressed choice in requisition form design, allowing providers to make independent medical necessity decisions on each test ordered. The guidance specifically stated that the agency does not design or approve requisition forms; but, some guidance on the form s contents was provided. Guidance for Requisition Form Content The form should solicit program information as necessitated by federal or private healthcare programs for accurate claim submission. Pursuant to Clinical Laboratory Improvement Amendments (CLIA) regulations, a standard requisition must solicit the following information found in the Electronic Code of Federal Regulations (e-cfr) : Ordering provider identification Patient s identification Patient s gender and age or date of birth Test(s) to be performed 52 Healthcare Business Monthly Potassium; serum, plasma or whole blood Sodium; serum, plasma or whole blood The ordering provider should have the opportunity to request only tests he or she deem to be medically necessary, rather than a panel that may include unnecessary tests. Per the OIG, The OIG believes the laboratory has an obligation to notify ordering providers that Medicare will only pay for tests that meet the Medicare coverage criteria and are reasonable and necessary to treat or diagnose an individual patient. Medicare coverage criteria is propagated through national and local coverage determinations (NCDs and LCDs). Both determinations are posted on the Centers for Medicare & Medicaid Services (CMS) website and you can find a Medicare administrative contractor s LCDs on its website. Forms used should solicit providers to submit medical necessity documentation in the form of ICD-10-CM diagnosis information for each test. They should also inform providers that Medicare generally does not cover routine screening tests except as authorized by statute. Recently Published Guidance The recently posted Corporate Integrity Agreement Between the Coding/Billing Auditing/Compliance Practice Management

53 To discuss this article or topic, go to Requisition Forms The ordering provider should have the opportunity to request only tests he or she deem to be medically necessary, rather than a panel that may include unnecessary tests. Office of Inspector General of the Department of Health and Human Services and Millennium Health, LLC provides clarifying guidance specific to toxicology requisition forms. This includes the following specific clarifications: Similar to the Compliance Program Guidance for Clinical Laboratories, requisitions should state boldly, Medicare will only pay for tests that are medically reasonable and necessary based on the clinical condition of each individual patient. Tests should be listed clearly and distinctly. Consistent with the conscious choice guidance, providers should use notations to order individual tests (except for test panels established by CMS or other payer billing codes or policy). Physicians may not order tests under custom profiles, standing orders (unless the physician has established a specific standing order for an individual patient for a defined period of time based upon a determination of the medical reasonableness and necessity of doing so), or panels (except for test panels established by CMS or other payer billing codes or policies). Claims should not be submitted to federal healthcare programs without a valid requisition form. This is based on CLIA regulations where clinical laboratories are required to have an order for testing. (e-cfr) Any test on the requisition form subject to applicable NCDs or LCDs should be identified. The form should also provide instructions on how the ordering physician can access additional information regarding those NCDs and LCDs, including links to applicable determinations on the CMS website. Notify providers that tests submitted for Medicare and Medicaid reimbursement must meet program requirements or the claim may be denied. This includes documentation to meet medical necessity edits published in NCDs and LCDs. Confirmatory and quantitative tests must be listed separately on the requisition form, which must indicate that each test should be ordered only when it s medically necessary to have information that screening with qualitative immunoassays alone will not provide. Blanket confirmatory testing is not recommended. Confirmatory tests should be used only when the provider determines them to be medically necessary. When tests are not offered individually, providers should have the option of ordering the tests by writing in a Special Instructions section of the requisition form. Under negotiated rule making, a consensus was reached that allows laboratories to accept unsigned requisition forms for Medicare laboratory diagnostic services. (HHS, 2001) This concession has led to many Comprehensive Error Rate Testing errors where laboratories are unable to provide signed orders when requested by Medicare reviews. (HHS, 2015) Although the negotiated rule allows for unsigned requisition forms upon request, a laboratory should be able to produce or obtain from the ordering provider the documentation to support medical necessity of the provided and billed laboratory service. With this clarifying guidance, facilities and laboratories providing toxicology drug testing, especially those for pain management, are encouraged to review their requisition forms for compliance. Resources: Electronic Code of Federal Regulations, Standard: Test request, 42CFR : cgi-bin/text-idx?sid=7779bcfa83d70334c6e b4158&mc=true&node=se _ 11241&rgn=div8 HHS, Federal Register, 42CFR410 ( ), (November 23, 2001): HHS, Guidance to Address Billing Errors, Medicare Quarterly Provider Compliance Newsletter, volume 6, issue 1, October 2015, ICN OIG, Corporate Integrity Agreement Between the Office of Inspector General of the Department of Health and Human Services and Millennium Health, LLC., October 16, 2015): HHS, Federal Register, 63 FR 163 ( ), August 24, 1998: Frank Mesaros, MPA, MT(ASCP), CPC, CPCO, is CEO of Trusent Solutions, LLC, a management consulting firm specializing in the laboratory industry. Trusent provides revenue stream integrity services to regional laboratories, hospital based laboratories, and physician office based laboratories. He is a member of the Harrisburg, Pa., local chapter. AUDITING/COMPLIANCE February

54 PRACTICE MANAGEMENT By John Verhovshek, MA, CPC What Employers Really Look for in a Job Candidate Let s cut the fluff, get real, and talk to professionals who are responsible for hiring. image by istockphoto portishead1 As a prospective employee searching for a coding position, you know that simply getting noticed is a huge hurdle, which leads to an important question: What are employers really looking for as they review resumes and interview applicants? To give you some insight, here are opinions from individuals with experience filling open positions in their organizations. Although they differ regarding the importance of coding experience, they all stress the need for candidates who are flexible, demonstrate professionalism, have a willingness to learn, and are careful to sweat the small stuff. 54 Healthcare Business Monthly Geanetta Agbona, CPC, CPC-I Educator, CGS Medical Billing Service, Charlotte, N.C. Little things can mean a lot, is the old adage. Being a medical biller, coder, or even an instructor requires attention to detail. Misspelled words or transposed numbers is indicative of a job candidate s level of professionalism. Did the candidate ensure that I can contact her? Supplying outdated personal details (i.e., phone number) is the worst mistake you can make. Coding/Billing Auditing/Compliance Practice Management

55 Employers Can I read the resume? I ve been given resumes that were creased, crumpled, and some even carried traces of the last take out order. I kindly returned them. The resume is an invitation to get to know the candidate. Invitations should always be given properly. KISS (keep it simple, sister): Too much information can be overbearing. Provide information that is relevant to the position and supports the skill set required. I am located in the South. Southerners often have nicknames they prefer to go by; however, it is more professional to use your real name on a resume. Use the same labeling and formatting throughout your resume. Be consistent with the style of your resume. If using a template, be sure older material or directions inside of the template have been removed. Rebecca Bakke, CPC-A Director of Billing, Physicians Ally, Inc., Littleton, Colo. Here are some things I look for in a resume: How long have you spent in previous positions? If you have a track record of short-term positions and seem to jump around between jobs, I move to the next resume. Spelling and grammatical errors do not impress. Don t say you are a perfectionist and spell it incorrectly. If you include billing and coding information in your resume, make sure it makes sense. Saying you are proficient in ICD-9 and CPT-10 makes me question your knowledge. Have a professional sounding contact address. Pam Brooks, MHA, CPC, COC, PCS Coding Manager, Wentworth-Douglass Hospital, Dover, N.H. Include your certifications in the heading of your resume: for example, Mary Smith, CPC. Most coding positions require a certification. I appreciate not having to scroll through the entire resume to learn if Mary is certified. I also pay attention to whether the candidate has listed experience or education that is required for the position. If so, that means the Spelling and grammatical errors do not impress. Don t say you are a perfectionist and spell it incorrectly. person read the job description and knows that she or he is a viable candidate. Finally, I look for errors spelling, grammar, etc. If those are present in the resume, it goes right in the trash. This sort of resume represents an individual who doesn t take pride in his or her work. Rhonda Buckholtz, CPC, CPC-I, CPMA, CRC, CHPSE, CENTC, CGSC, CPEDC, COBGYN VP Strategic Development, AAPC The most important thing I look for in a new employee is initiative. Experience is nice, but if you don t have ambition, the desire to learn new things, and the gumption to reach outside the box, it s not worth it to me to invest time. Sell yourself to your employer: Why are you better than someone else? I have applied for many jobs where I didn t have the exact qualifications they advertised. Selling why you are a better candidate works, in my experience. MariaRita Genovese, CPC, PCS Administrator, Oncology Revenue Cycle, Thomas Jefferson University, Philadelphia, Pa. When screening resumes, there are several important clues that reveal the potential fit of a candidate: Objective or Summary: How does the candidate describe his- or herself? Does the candidate s objective complement the needs of the position? Length of time in each position: Job-hopping can indicate lack of dedication, or perhaps some other issue. Years of experience in similar position(s): Did responsibilities increase/change over time? Qualifications for the position: Does the candidate possess the skills and knowledge needed? Growth in field: Is the candidate focused? Does the candidate participate in a professional organization to stay current in the field? PRACTICE MANAGEMENT February

56 Employers To discuss this article or topic, go to PRACTICE MANAGEMENT I feel that every resume needs to be one page. No matter how wonderful the applicant, I rarely get to the second page. Completion of initiatives/projects: Does the candidate give examples of successful participation in work-related projects? Does he or she indicate an ability to work in team situations? Computer literacy: Is the candidate proficient with the appropriate equipment and software? Education: Does the candidate indicate a desire to increase knowledge and skill? Community involvement: A desirable candidate will indicate the desire to do more, as well as indicate interests beyond hisor herself. image by istockphoto Wavebreakmedia Kim Reid, CPC, CEMC, CPC-I, CPMA Manager, Professional Coding, University of Vermont Medical Center, Vt. As the hiring manager of a professional coding department, there are certain things I look for when hiring a professional coder. The most important qualification is that they possess a coding certification credential through AAPC. If this is not listed on the resume, I immediately discard the candidate. If certification has been obtained, I look to see what type of experience the candidate has. I do not look specifically for coding experience because those skills can be taught and tailored to our organization. It is much more important for the candidate to be able to work calmly under pressure, have an open, flexible mind, and know how to deal with evolving rules. Sometimes, past experience in a completely different field can teach a skill that would help a coder be a better communicator. For instance, if someone worked at a daycare with special needs children, this may indicate that person understands how to explain things in many different ways until the message is understood. Although the candidate may not have direct hospital or coding experience, prior experience can have a huge impact on how he or she interacts with physicians when the message is not always a positive one. Ellen Maura Wood, CPC, CMPE Practice Manager, Seacoast General Surgery, Dover, N.H. A resume is your chance for a first impression, and you usually do not get an opportunity for a second first impression. I want to see to and from dates, and an explanation of break periods between jobs. If the break in service is due to being a stay-at-home mom or dad, that doesn t mean I won t consider the applicant. Participation in youth groups, coaching, and raising a family all offer valuable skills that can transition into a medical office position. For example, holding a position of president of the Parent Teacher Organization requires excellent mediation skills, which are essential in physician office. I feel that every resume needs to be one page. No matter how wonderful the applicant, I rarely get to the second page. I always request a cover letter. One reason for this is to see if an applicant can follow directions. It also shows me whether the applicant took the time to adapt the cover letter to the position, and what he or she expects for a salary. This narrows the applicant pool tremendously. Many applicants ask for a crazy salary, and some send out resumes in bulk, showing they aren t really vested in the job. Finally, having accurate information is imperative. I have called phone numbers listed on resumes that are no longer in service; or worse, applicants have listed their present work numbers as a number to contact them. It bears repeating: You only have one chance to make a good first impression. John Verhovshek, MA, CPC, is managing editor at AAPC and a member of the Hendersonville-Asheville, N.C., local chapter. 56 Healthcare Business Monthly

57 Crack specialty coding with the American Medical Association s 2016 CPT Coding Essentials series the perfect companion to your CPT Professional codebook Strengthen your knowledge and simplify your research with the new 2016 CPT Coding Essentials series. This six-book series includes illustrations and plain English descriptions for code selection in a CPR code-driven format. Each book focuses on CSM reimbursement and medical necessity information. AMA This is the only specialty series that comes straight from the source of CPT code the AMA and exclusively provides the CPT Editorial Panel s Guidelines instructions on ICD-10-CM documentation and coding. Each CPT Coding Essentials title includes CPT code for surgeries, medicine and ancillary services, paired with: Illustrations and plain English descriptions of the service represented by the code Official, code-specific instructions and parenthetical information from the AMA s CPT Professional codebook ICD-10-CM codes mapped by coding experts RVUs, global periods and modifier payment rules References to CMS s Pub 100 and the AMA s CPT Assistant newsletter To learn more, visit amastore.com or call (800) Series includes: CPT Coding Essentials for Cardiology 2016 CPT Coding Essentials for General Surgery & Gastroenterology 2016 CPT Coding Essentials for Obstetrics and Gynecology 2016 CPT Coding Essentials for Ophthalmology 2016 CPT Coding Essentials for Orthopedics: Lower Extremities 2016 CPT Coding Essentials for Orthopedics: Upper Extremities And Spine February

58 CODER S VOICE By Ken Camilleis, CPC, CPC-I, COSC, CMRS, CCS-P Tap into the Value of the CPC-A Apprentices provide a fresh perspective, are a spring of knowledge, and provide a practical staffing solution. The next time you have an open position that doesn t require years of in-the-trenches coding experience, consider hiring a Certified Professional Coder Apprentice (CPC-A ). Students of AAPC s Professional Medical Coding Curriculum (PMCC) work very hard to achieve their credentials. They go through a rigorous, comprehensive coding training program that is tried and true. Earning the CPC-A credential speaks for the individual s experience from an educational perspective. The knowledge the CPC- A brings to the table is fresh and pliable. Offering a CPC-A an opportunity to acquire the real world experience he or she needs is a smart investment. Look beyond the A, and recognize the value of the CPC-A. CPC-A vs. CPC Typically, the argument against hiring a CPC-A is that more money will be spent on training than on the differential of a seasoned coder s salary and the minimum budget for an open position. That may be true to some extent, but even a seasoned coder will still require training in regards to protocol, corporate policies, physician and payer guidelines, etc. Overcome CPC-A Stigma in the Workplace Sometimes hiring managers won t interview a CPC- A for a coding position when there are experienced coders applying. To create an even playing field, you might suggest human resources adopt a three-tiered approach to hiring. For example, if a candidate makes a good impression at the interview, the next step is an entrance exam (either broad-based in coding or with a few scenarios focused on a particular specialty, depending on the job). Entrance exams are now considered common practice when hiring CPCs, and should be extended to CPC-As, as well. The third step is the call-back interview. Another way to get a CPC-A s foot in the door is to conduct working interviews, where a strong CPC-A job candidate is hired for a short period (e.g., one to three weeks) to fill an immediate need and then, if all goes well, considered for a temporary-to-permanent position. If the CPC-A doesn t work out, the business doesn t suffer much of a loss. In fact, from a time perspective, you may actually come out ahead because the temporary employee was able to provide a necessary service (such as attenuating a backlog in coding validation, charge entry, or payment posting). Benefits of Hiring a CPC-A Health systems, hospitals, and clinics often fill the void by having inhouse employees take on extra work, perhaps, dipping into overtime dollars rather than hiring a new employee who does not have coding experience. This might work for the short term, but eventually employees become tapped out, and the theoretical benefits are lost. Consider that CPC-As may be willing to start at the lowest pay tier to get their foot in the door. Reasonably, full-fledged CPCs should be paid commensurate to their experience. Consider, also, that the ex- image by istockphoto Daniel Ernst 58 Healthcare Business Monthly

59 Value of the CPC-A Consider that CPC-As may be willing to start at the lowest pay tier to get their foot in the door. perienced coder may not like to perform repetitive or mundane tasks; whereas a CPC-A may review documentation or do charge entry all day, without complaining. If you are still bent on hiring an experienced CPC to fill an entry-level position, realize that he or she may look for a better offer elsewhere leaving you with no one to do the job. Million Dollar Question The bottom line question is: How do CPC-As get the experience needed to become full CPCs? If no one will hire them because they don t have experience, they will never gain the experience employers seek. With the support of CPC-As and managers who hire them, a solid infrastructure can be built: CPC-As will become CPCs, new CPC-As will fill their lower-level positions, and everyone is happy. Resources for CPC-As : Join AAPC on Facebook, where members post questions, accomplishments, and job openings for healthcare business professionals. Practicode helps members with a CPC-A or Certified Outpatient Coding (COC ) credential get real-world experience in coding actual medical charts ( Visit AAPC online forums ( and attend local chapter meetings ( to network with other coders who may be able to help you to get coding experience. Speak Up for CPC-As I encourage coders nationwide to show this article to their department managers when a low-tier coding position opens up or an emergent or unplanned situation creates a need for additional staff. Ken Camilleis, CPC, CPC-I, COSC, CMRS, CCS-P, is an educational consultant and PMCC instructor with Superbill Consulting Services, LLC. He is also a professional coder for Signature Healthcare, a health system covering much of southeastern Massachusetts. Camilleis primary coding specialty is orthopedics. Camilleis is a member of the Cape Coders local chapter, in Hyannis, Mass. AAPC WORKSHOPS New 2016 Events NOW AVAILABLE! Find a workshop near you: AAPC - Workshop AAPC's workshops give you more of what you need: 40+ different cities throughout the country Authored and presented by leading experts Up to 6 CEUs 4 hours of live presentation each In-depth information on critical topics Learn more at WORKSHOP FEATURES Interactive and hands-on exercises with case studies 4-hours includes presentation and skill-building practice Comprehensive workbook including presentation slides Access on-demand recording February

60 NEWLY CREDENTIALED MEMBERS Magna Cum Laude Alison Elaine Newman-Barrow, CPC, CPMA Argelyn Alvez, CPC-A Axel Ortiz, CPC-A Cammie Lindner, CPC, CPMA Carly M Hansen, CPC Diane May, CPC Elaine Haddad, CPC-A Elizabeth F. Winborn BA, CHDS-R, CPC-A Jennette Martinez, CPC-A Jodi Houston, CPC, CPMA, CRC Karthik Radhakrishnan, COC-A Kathleen McKula, CPC, CPMA, CEMC, CFPC Kelly Turner, CPC, CIRCC Kimberly Brown, CPC-A Kristi Allery, CPC-A Kristina Apke, CPC-A Margene Holak, COC-A Maria Halagan, CPC, CRC Maria T Sanders, COC, CPC, CPMA, CPC-I Marianito Gatuz, CPC-A Michael Kushner, CPC-A Michael Mojena, CPC-A Pradeepa P Nair, CPC-A Rebecca Snow, CPC-A Ronni J Knight, CPC, CRC Samantha Combs, CPC-A Stephanie Erickson, CPC CPC Adozinda Mason, CPC Adrianna Tilton, CPC Akila Pasupulati, CPC Al Moses, CPC, CIRCC Alexis Hernandez, CPC Alexis Winburn Winstead, COC, CPC, CEDC Alicia M Kammerzell, CPC Alka Singh, COC, CEDC Alyce Hollis, CPC Alyssa Nicole Garcia, CPC Amanda Curry, CPC Amanda N Smith, CPC Amanda Reffett, CPC Amanda Rojas, COC Amira Benjamin, CPC Amy Kahn, CPC Amy Lasure, COC Andrea Burrows, CPC Angalene Gamez, CPC Angela J Jepson, CPC Angela Mitchell, CPC Angela Swartz, CPC Angie Swaggerty, CPC Ann Robertson, CPC Antigone Chandler, COC, CPC April Davis, CPC April Law, CPC Ariadna Garcia, CPC Ashley Caballero, CPC Ashley Pitts, COC Ashley Ryan, CPC Asma Umbreen, CPC Athena Kellner, CPC Barbara Garner, CPC Barbara Haines, COC, CPC Barbara Smith, CPC Barrie George, CPC Becky Roberts, CPC Belinda Beran, CPC Belinda Caballero, CPC Belkis Garcia Vazquez, CPC Berenice Putnam, CPC-P Betty Thompson, CPC Bob Andrus, CPC Brandi Hicks, COC, CPC, CGIC, CUC Brandy Lynn Robinson, CPC, CEDC Bree Howington, CPC Brenda Allen, CPC Bridget Nutter, CPC Brittany Simmons, CPC Cara Kromer, CPC Carlicia Lloyd Wade, CPC Carmelita Strickland, CPC Carolyn Skelton, CPC Catherine Kitko, CPC Catherine Traister, CPC Catrina Sizemore, CPC Chevette Lashawn Jones-Smith, CPC Chris Hughes, CPC Christine B Smith, CPC Christine Kelley, CPC Christine MacPhail, CPC Christy Lewis, CPC Constance A Parker, CPC Corinne Tometich, CPC Courtney Clark, CPC Cristin Freese, CPC Cynthia Deschapell, CPC Dana Antle, CPC Dana Lee Shade, COC, CPC, CPC-P Dana Thornton, CPC Daniel Gerard Dery, CPC Danielle Thoin, CPC Dawn M Amato, CPC Dawn Nelson, CPC Debbie Altman, COC Debbie Edwards, CPC Debbie Wagner, CPC Deborah A Meisinger, CPC Deborah Gois, CPC Deborah Harris, CPC Deborah Justice, CPC Debra Halvorson, COC Debra Rae, CPC Delana Stevens, CPC Deven Brown, CPC Diana Hurt, COC Diana Margarita Gamez, CPC Diane Els, CPC Diane P Richardson, COC, CPC Donna Arbutiski, CPC Donna Hailey-Welker, CPC Elaine Meyer, CPC, CENTC, CUC Eleanor Stewart, CPC Elizabeth Jane Williamson, CPC Elizabeth Ann Becker, CPC Erin Heitshusen, COC, CFPC Eva Eubanks, CPC Faith Michelle Lambour, CPC Frances Tomblin, CPC Gabriel Sena, CPC George Fisher, CPC Georgette Helen Covert, COC, CPC Gerilyn Moilanen, CPC Gina Vanderwall, OCS, CPC Gretchen Church, CPC Gretchen K Gilliland, CPC Haryani Kwanarta, CPC Heather Martin, CPC Heather Vanderoef, CPC Heather Watson, CPC Hilary C Crosby, CPC Hollie D Howell, CPC Ildiko Ferro, CPC Irene N Sangalang, CPC Irene Wilson, COC, CPC Jacey Timmes, CPC Jacqueline Akbar, CPC Jamie Maronde, CPC Jana Barnett, CPC Janella Miles, CPC Janet K Vlasak, COC, CPC Janet Keller, CPC Janet Myers, CPC Jean Papin, CPC Jeanne Riley, CPC Jeanne-Marie Allred, CPC Jennifer Grissom, CPC Jennifer Kubetin, CPC Jennifer Martinez, CPC Jennifer Moore, CPC Jennifer Stadelmann, CPC Jessica Calderon, CPC Jessica Lujan, CPC Jessica Sharnee Mathis, CPC Jill Blake, CPC Jill Hale, CPC Jo Ann Randall, CPC Joan McCoy, CPC Joan Mohr, CPC Joanna O Neill, CPC Joette Fetty, CPC Joseph Reaume, CPC Joyce Eroh, CPC Judi Lerner, CPC-P Juka Robinson, CPC, CHONC July A Groves, CPC Kacey Schaefer, CPC Kara Carr, CPC Karen Ulman, COC, CPC Karen Betz, CPC Karen Dixon, CPC, CPMA Karen House CPC, CPC Karen Morgan, CPC Karen S Milligan, CPC Karen Stevens, CPC Karlene Young, CPC Kathleen Kucera, CPC-P Kathleen Williamson, CPC Kathy Reed, CPC Katie Allen, CPC Kay Pastora Townsend, CPC Keasha Lundy, CPC Keira Stockdale, CPC Keisha M Jones, COC, CPC Keisha M. Renee, CPC Kelli Marie Kronenbitter, CPC Kelli Waldrep, COC, CPC Kelly J White, CPC Kelly Riggs, CPC Kenya W Harris, CPC Keri Abbott, COC Kim Beard, CPC Kimberly A Norris, CPC Kimoy Griz, CPC Kirsten M LeBlanc, CPC Kristal N Wessels, CPC Kristen Peterson, CPC Kristin Macedo, CPC Krystal Carter, CPC Krystle Dodd, CPC Kymberlee Lucas, CPC Latosha Cooley, CPC Latoya Silvera, COC, CPC Laura Anderson, CPC Laura Jeter, COC, CPC Laurie Hines, CPC Laurie Toney, CPC Leah Enright, CPC LeAndrea Mack, CPC LeeAnne Sandberg, CPC Leigh Trussell Wise, CPC Lillian S Convery, CPC Linda Butts, CPC Linda Haake, CPC Linda Lewis, CPC Linda Perez, CPC Linda Veloso, CPC Lisa Baker, CPC Lisa Bradshaw, COC, CPC Lisa Cohen, CPC, CPB Lisa Heyman, CPC Lisa Nicholson, CPC Liyuan Beng, CPC Liza B Garlitos, CPC-P Lois Hammer, CPC Lola Chunn, CPC Lori Spurlock, CPC Lori Strother, CPC Lori Vickery, CPC Lorie A Mcreynolds, CPC Lorie Anderson, CPC Lorie Peters, CPC Lorine Annette Ledoux, CPC Lorraine King, CPC Luana Ciccarelli, CPC Lucy Maples, CPC Lynn Cosentino, CPC Lynn Landry, CPC Lynn Marie Neubauer, COC, CPC Lynne Wright, CPC-P Mackenzie Joan Francis, CPC Malgorzata Nowak, COC, CPC Malinda Waters, CPC Marcella Kay Henderson, COC, CPC Marcia A Maar, MFA, COC, CPC Mardi Harmer, CPC Margaret E Gonzalez, CPC Maria Gonzalez, CPC Maria P Washington, COC, CPC Maria Sabrina Mariano, CPC Maria Ursua-Gonzalez, COC Marie Samir Bsaybes, CPC Mariela Cortez, CPC Maritza Rodriguez, CPC Marsha Gauthier, CPC Mary C Long, COC, CPC Mary Fischer Golda, CPC Mary Fox, CPC Mary Gross, CPC Mary Williams, CPC MaryAnn Jones, CPC Mayra E Ramirez, COC, CPC Meaghan Eckler, CPC Melanie Natasha Hipp, CPC Melba Hogue, CPC Melissa Barron, CPC Melodie Lockhart, CPC Michael Thomas, CPC Michele Crespo, CPC Michele Stephenson, CPC Michelle Hammerschmidt, CPC Michelle Hentges, CPC Michelle Owen, CPC Michelle Quinn, CPC Michelle Rolerson, CPC Monica Murphy, CPC-P Monica Stovall, CPC Natasha Gonzalez, CPC Nicole Conditt, CPC Nicole Statham, CPC Pam Callahan, CPC Pam Hamer, CPC Pamela Sue Keen, CPC Pamela Towle, CPC Patricia Ann Willis, CPC Patricia Markin, CPC Patricia Reddy, CPC Patrina Dickens, CPC Paula W Swaim, CPC Pia Thorbjornsen, CPC Priscilla Paulino, CPC Rachel Craig, CPC Raciel Fuentes, CPC Raquel Galbreath, CPC Relinda Juan, CPC Renee Hamlin, CPC Renee Lokken, CPC Renee Shadley, CPC Richard White, CPC Rosa D. Nemnom, CPC Rosa M Estrada, CPC Rosemary Hearn, CPC Rosemary Varano, CPC Sabrina Maria Jones, CPC Sanquenetta Williams, CPC Sara Love, CPC-P Sarah Cass, CPC Sarah Lambdin, CPC Sarah O Brien, CPC Sarah Whitehead, CPC Scott Clarke Sr, COC, CPC Seanell Marshall, CPC Selma Dyche, CPC Shamra Hicks, COC, CPC Shannon Hilling, CPC Shante M Griffen, COC, CPC Sharon Childress, COC, CPC Sharon Smedstad, CPC Sheila Kazmerski, CPC Shelby Cruz, CPC Shelby Spooner, CPC Sherri Patrick, CPC Sherry Buffkin, CPC Sonia Bryan, CPC Stacey Cox, CPC Stacey Dominique, CPC Stacey Dumond, CPC Stacie Anderson, CPC Stacy Bartley, CPC Stacy Gerhart, CPC Stacy Shumate, CPC Stefanie Repp, CPC Stephanie Henson, CPC Stephanie L Ramos, CPC Stephanie Malynn Sell, CPC Stephanie McRae-Robinson, CPC Stephanie Newman, CPC Steve Costello, CPC Susan D Hagedorn, COC, CPC, CPC-P Susan M Weaver, COC, CPC Susan Turley, CPC Talina D Woods, CPC Tammi Counterman, CPC Tara Sanford, COC Tarsha Carroll, CPC Tawnya Mckague, CPC Teresa Elaine Livengood, COC, CPC Teresa L Hall, CPC Terri Duppstadt, COC Terri Lane Coomer, CPC Terri Riedl, CPC Terri-Lynn Marie Logan, CPC Terry Kendall, COC Theresa Lester, CPC Timothy Eaton, COC Tina Flint, CPC Tina M White, CPC Tonya Travis, CPC Tonya Wageman, CPC Tracey Batson, CPC Traci Ann Hayslip, CPC Traci L SuSong, CPC Tracy Gettys, CPC Tracy Shea, COC, CPC Trudy-Ann A Porter, CPC Tyler Morris, CPC Vanessa Cull, CPC Vicki D Hensley, CPC Vo Chung, CPC William Raucci, CPC Yania Audia, CPC 60 Healthcare Business Monthly

61 NEWLY CREDENTIALED MEMBERS Yesenia Hernandez, CPC Yolanda Lorraine Mills-Bosley, CPC Apprentice Aaron Clairmont, CPC-A Aatiraa Rajan, CPC-A Abdulla Shet, COC-A Abrar Khan, CPC-A Adam Pell, CPC-A Adeana Shoemaker, CPC-A, CPB Adele McLennon, CPC-A Adrienne Pendergast, CPC-A Agnes A Osuji, CPC-A, CRC Aileen Yema Gusi, CPC-A Aimee DiTucci, CPC-A Aimee Relucio, CPC-A Ajay Kumar Koppineni, COC-A Ajna PM, CPC-A Akash Kumar, CPC-A Al Beckles, CPC-A Alexandra Contini, CPC-A Alexandra Manzanares, CPC-A Alexia Kennedy, CPC-A Alexis Sommer, CPC-A Alicia Cordero, CPC-A Alicia Costelloe, CPC-A Alicia Mitchell, CPC-A Alicia Rich, CPC-A Alicia Wolfinger, CPC-A Alicyn Beeman, CPC-A Alli Coggan, CPC-A Allison E. Finer, CPC-A Allison Marie SanJuan, CPC-A Allison Washkurak, CPC-A Allyson Arnold, CPC-A Alvin Joseph Dela Cruz Tapia, CPC-A Alwyn Premraj, COC-A Alyssa Foster, CPC-A Alyssa Futrell, CPC-A Alyssa Rae Parker, CPC-A Alyssa Rogers, CPC-A Amanda Boehmer, CPC-A Amanda Broome, CPC-A Amanda Childress, CPC-A Amanda D Tate, CPC-A Amanda Harris, CPC-A Amanda Middleton, CPC-A Amanda Pearman, CPC-A Amanda Reeves, CPC-A Amanda Workman-Rissman, CPC-A Amber Ballard, CPC-A Amber Eleanor Hall, CPC-A Amber Marie Sylvester, CPC-A Amber Nickole Suber, CPC-A Amber Nicole Rose, CPC-A Amber Perkins, CPC-A Amber R Coates, CPC-A Amber Schisler, CPC-A Amber Whiteman, CPC-A Amit Vishnu Sutar, CPC-A Amy B Pearce, CPC-A Amy Grimmett, CPC-A Amy Huffman, CPC-A Amy J Carr, CPC-A Amy London, CPC-A Amy Perez, CPC-A Amy Potts, CPC-A Amy Williams, COC-A Ana Arnold, CPC-A Ana Cartaya, CPC-A Ana Jones, CPC-A Ana Leota, CPC-A Ana P Baptista, CPC-A Ananta Gowrishankar Valavala, COC-A Ancy Anoop, CPC-A Ancy Thadikuttil Sabu, CPC-A Andrea Frank, CPC-A Andrea Haynes, CPC-A Angel Lea Wolfe, CPC-A Angela Gray, CPC-A Angela Hammes, CPC-A Angela McGlumphy, COC-A, CPC-A Angela Morgan, CPC-A Angela Ramirez, CPC-A Angie Gibson, CPC-A Anh Tran, CPC-A Aniket Bagate, CPC-A Anil Kumar Poumjula, COC-A Anil Solomon Raj, COC-A Anila Karunakaran, CPC-A Anila Taraj, CPC-A Anitha Appam, CPC-A Anitha Bulagakula, CPC-A Anitha Xavier, COC-A Anitra Massey, CPC-A Anjanette Jones-Williams, CPC-A Anju Jaya, COC-A Ankita Purkayastha, CPC-A Ankur Sharma, CPC-A Ann Halligan, CPC-A Anna Barnes, CPC-A Anna Dominique Carag, CPC-A Annamaria DiGisi, CPC-A Anne Mitchell, CPC-A Anne Sanchez, CPC-A Annette Elizabeth Benson, CPC-A Anthony DiMeo, CPC-A Anthony Ferreira, CPC-A Anthony Parker Kidwell, CPC-A Anto Arockiadass, COC-A Antonia Gaspard, CPC-A Antonio Courtney, CPC-A Antonio M. Moreno, CPC-A Antronell Boyce, CPC-A Anu Mahadevan, CPC-A Anu Mary, CPC-A Anusha Puli, COC-A Anusree C V, CPC-A Arjun Singh Tanwar, COC-A Arlene Mae Sullivan, CPC-A Aron, CPC-A Arya Sreejith, CPC-A Ashleigh Fisher, CPC-A Ashley Cuevas, CPC-A Ashley Hall, CPC-A Ashley Morgan, CPC-A Ashley Rainville, CPC-A Ashley Richards, CPC-A Ashuthosh Bali, CPC-A Ashwini Reddy Ammasani, CPC-A Audrey Doncell, CPC-A Badha Ratnavamshi, CPC-A Balaraman Murugan, CPC-A Bangaram Chamarty, CPC-A Barb H Price, CPC-A Barbara O Neil, CPC-A, CPC-P-A, CPB Barbara Taylor, CPC-A Barbara Turner, CPC-A Beatriz Benitez, CPC-A Becky Barckhoff, CPC-A Bernadette James, CPC-A Bernadette Williams, COC-A Bernie Amaro, CPC-A Beth Hudgins, CPC-A Bharathi Durgavarapu, COC-A Bhumi Bharodiya, CPC-A Bhumikabahen Patel, CPC-A Bianca McBride, CPC-A Binu Moideen, COC-A Binu Samuel, CPC-A Biplab Pakhira, CPC-A Blecita D Mascarenhas, CPC-A BN Yuvaraj, COC-A Bobbi Mckenzie, CPC-A Bobbie J Fifer, CPC-A Bonita Lakay Donald, CPC-A Bonnie Critchfield, CPC-A Boopalan Vimala Nathan, CPC-A Brandi Gagliano, CPC-A Brandie Petet, CPC-A Brandy Libby, CPC-A Brandy Maxam, CPC-A Brenda CL Hardyman, CPC-A Brenda Holt, CPC-A Brenda J Ebel, CPC-A Brenda Malloy, CPC-A Brenda Mercier, CPC-A Brenda O Orona, CPC-A Brenda Pike, CPC-A Brenda Sy, CPC-A Brenna Hanken-Pike, COC-A Brian Lloyd Baker, CPC-A Brian Lloyd Baker, CPC-A Bridget Byrd, CPC-A Bridget Elliott, CPC-A Brittany Dunham, CPC-A Brittany Rambino, CPC-P-A Bujji Naga Seshu Reddy, COC-A Calvin Hardwick, CPC-A Camesha Waterman, CPC-A CaMesha Wright, CPC-A Candace Winters, CPC-A, CPB Carlo Almazar, CPC-A Carlo Aranas, CPC-A Carmen Nelson, COC-A Carol Cameron, CPC-A Carol Krebs, CPC-A Carol Wasp, CPC-A Carole Mcdonough, CPC-A Carolina Claxton, CPC-A Carolyn Segal, CPC-A Carrie DeHerrera, CPC-A Carrie DeMartini, CPC-A Carrie Finley, COC-A Casey Brame, CPC-A Casey Dunnivan, CPC-A Casey Minchey, CPC-A Cassie Basgall, CPC-A Catherine Heglar, CPC-A Cathleen Duchesneau, CPC-A Catlin Barnes, CPC-A Cecili Nida, CPC-A Celia Taruc Czechowicz, COC-A Chander Parkashh, COC-A Charles Monn, CPC-A Charles Snavely, CPC-A Chelsea Marie Lederer, CPC-A Cherie Krider, CPC-A Cherrylin Marie Foley, COC-A Cheruku Vishwa Prasad, CPC-A Cheryl Ann Odesse, CPC-A Cheryl Carmichael, CPC-A Cheyenna Costello, CPC-A Chris J Fourcade, CPC-A Chris Silva, CPC-A Chrisandrea Nguyen, COC-A Chrissie Parker, CPC-A Christie L McHaney, CPC-A Christina Fleming, CPC-A Christina Graff, CPC-A Christina Michelle Downey, CPC-A Christina Strayer, CPC-A Christine Brooks, CPC-A Christine Corradi, CPC-A Christine Jacela, CPC-A Christine K Cintron, CPC-A Christine Peet, COC-A Christine Shimada, CPC-A Christy Ranes, CPC-A Chrysten Fahey, CPC-A Ciara Jacosalem, CPC-A Cindy Bartlett, CPC-A Cindy Boor, CPC-A Cindy Donarski, CPC-A Cindy J Rollins, CPC-A Cindy O Brien-Hallberg, CPC-A Cinthya Garcia, CPC-A Clara Dugan, CPC-A Clark Wilcox, CPC-A Claudia Caesar, CPC-A Claudia De Jesus, CPC-A Claudia Uzhca, CPC-A Colleen Jensen, CPC-A Colleen Rought, CPC-A Colleen Sawyer, COC-A, CPC-A Colleen Wallis, CPC-A Collette J Castillo, CPC-A Connie Burke Parrish, CPC-A Connie Perez, CPC-A Connie Vaughan, COC-A Consuelo Robinson, CPC-A Corinne O Reilly, CPC-A Cory DeGregorio, CPC-A, CPB Courtney Braccioforte, CPC-A Courtney Cook, CPC-A Courtney Jacobson, CPC-A Crista Peter, CPC-A Cristi Colley, CPC-A Cristina Borden, CPC-A Cristy Helman, CPC-A Crystal Christiansen, CPC-A Crystal E Throop, COC-A Crystal Esaw, CPC-A Crystal Ierardo, CPC-A Cynthia Bates, CPC-A Cynthia Brown, CPC-A Cynthia Scheinholtz, CPC-A Cyrena Mace, CPC-A Dana Aspray, CPC-A Dana Jordan, CPC-A Dana Lyn Farrell, CPC-A Dana M Mattice, CPC-A Dana Morrison, CPC-A Dana Salcedo, CPC-A Dana Young, CPC-A Danelle Ferguson, CPC-A Daniel Jason Tucker, CPC-A Daniel Rich, CPC-P-A Danielle Busby, CPC-A Danielle Butler, CPC-A Danielle Maranda Wilson, CPC-A Danielle Pryor, CPC-A Danielle R Miller, CPC-A Danielle Schrupp, CPC-A Danita Latrice Bradford, CPC-A Daquavian Tyler, CPC-A Darcie Jenkins, CPC-A David Hutzler, COC-A David Moreno Andres, CPC-A David N Dow, CPC-A Dawn Coffman, CPC-A Dawn Dietert, COC-A Dawn Nation, CPC-A Dawn Strieby, CPC-A Deandrea French, CPC-A Deanna Wood, CPC-A Deanne Aby, CPC-A Debbie Dennison, CPC-A Debby Merryman, CPC-A Deborah Castellano, CPC-A Deborah Krauss, CPC-A Deborah Malany, CPC-A Debra Browne, CPC-A Debra Fidura, CPC-A Deena Horton, CPC-A Deena Lane, CPC-A Deepak Kumar Sharma, CPC-A Deepthy Surendran, CPC-A Demetra Stacey, CPC-A Deneice Pasciolla, CPC-A Denise Ann Peffer, COC-A, CPC-A, CHONC Denise Fluth, COC-A Denise Hartley, CPC-A Denise Rolfs, CPC-A Denise Stavinoga, CPC-A Dennis Barnette, CPC-A Devara Nagendra, COC-A Dewanda Wilson, CPC-A Dhanapal Balasubramaniyam, COC-A Dhirajkumar Sayajirao Ahire, CPC-A Diana Ellis, CPC-A Diana Ford, CPC-A Diana Moresi, CPC-A, CPC-P-A Diane Clark, CPC-A Diane Drumm, COC-A Diane Herr, CPC-A Dianne Ana Loren Anapi-Bernardo, CPC-A Dianne Wright Smith, CPC-A Dinesh Gunukula, CPC-A Dinesh Kukatla, CPC-A Divya Kankanala, COC-A Divya Sekar, COC-A Dixonpaul Premkumar, CPC-A Dolores Katherine Beck, CPC-A Donald Anthonisamy, CPC-A Donna Brady, CPC-A Donna Dyer, CPC-A Dora A. Rosapepe, CPC-A Doralis Betancourt, CPC-A Doretta Healy, CPC-A Dorys Jijon, CPC-A Doug Fox, CPC-A Dulonda Leggs, CPC-A Eileen Bishop, CPC-A Eileen Williams, CPC-A Eleanor Doherty, CPC-A Elena Doyle, CPC-A Elizabeth Collins, CPC-A Elizabeth Day, CPC-A Elizabeth Hart, CPC-A Elizabeth Kuhn, CPC-A Elizabeth Nguyen, CPC-A Elizabeth Reed, CPC-A Elizabeth Rios, CPC-A Ellen L Flick, CPC-A Elsa Escalera, CPC-A Elsa Esquivel-Schmolke, CPC-A Emily Cliber, CPC-A Emily Kingshott, CPC-A Emily Smith, CPC-A Emmarie Jane Loteyro, CPC-A Enrique Ramos, CPC-A Enrique Solis Lafont, CPC-A Eric Holland, CPC-A Erica Brown, CPC-A Erica Gilmore, CPC-A Erica Hettwer, CPC-A Erica Lynn Moore, CPC-A Erik Brown, CPC-A Erika Holbrook, CPC-A Erika McHugh, CPC-A Erin Dallas, CPC-A Erin Davis, CPC-A Erin Fogolini, CPC-A Erin Sabin, CPC-A Estela Robins, COC-A Faith A. Matthews, CPC-A Faith Bush, CPC-A Felicia Williams, CPC-A Feroz Khan Pathan, COC-A Franklina Marimuthu, CPC-A Gabette O Young, CPC-A Gabrielle Wenger, CPC-A Ganesh Irusappan, COC-A Ganesh Redekar, CPC-A Gayla R Lewis, CPC-A, CPB Gellemanie Niki Rouzard, CPC-A February

62 NEWLY CREDENTIALED MEMBERS Gemma Comunale, CPC-A Genevieve Pickering, CPC-A Gerald Long, CPC-A Gian Stacy Del Pilar Espena, CPC-A Gina Barnes, CPC-A Gina Vega, CPC-A Gorantla Bangaru, COC-A Grace Targonski, CPC-A Guduri Lakshmi Hema, CPC-A Gustavo Mendoza, CPC-A Halyn Le, CPC-A, CIRCC, CPMA Hannah Ithiel Gatchalian, CPC-A Hardin Davis Yeuell Jr, CPC-A Harish Kumar, CPC-A Harish Ramdas Suryawanshi, CPC-A Hatty Tsai, CPC-A Heather Hendricks, CPC-A Heather Paradise, CPC-A Heather Rose McClain, CPC-A Heather Summers, CPC-A Heather Valchar, CPC-A Heather Yothers, CPC-A Heidi Kostas, CPC-A Heidi Lewis, CPC-A Hema Swamy, CPC-A Hilary Heggen, CPC-A Himabindu DS, CPC-A Himabindu Harkar, CPC-A Himmat Singh, CPC-A Holly Jackson, CPC-A Holly Michele Carruth, CPC-A Holly Potter, CPC-A Holly Wallace, CPC-A Hope Marini, CPC-A Humaira Fathima, CPC-A Ian Atkins, CPC-A Igor Doroshchuk, CPC-A Imran Basha A, COC-A Imran Shaikh, COC-A, CPC-A Indu Rajesh, CPC-A Ingrid Saintelien, CPC-A Irina Shlyaeva, CPC-A Jaclyn Smith, CPC-A Jacqueline Abat, CPC-A Jacqueline Lehman, CPC-A Jacqueline Ruplis, CPC-A Jade Litt, CPC-A Jadyn Whitley, CPC-A Jai Maheswaran Baskaran, COC-A Jaicy Jose, CPC-A Jaime Blakeway, CPC-A Jaime Regener, CPC-A Jamie McCarthy, CPC-A Jana Sever, CPC-A Janel Greeley, CPC-A Janel Roylance, CPC-A Janelle Simpson, CPC-A Janet Salazar, CPC-A Janette Allen, CPC-A Janette Cameron, CPC-A Jansi Rani Ponnusamy, CPC-A Jaqui DeWitt, CPC-A Jared Wales, CPC-A Jashanpreet Kaur, CPC-A Jasmina Alshawy, CPC-A Jasmina Alshawy, CPC-A Jason Pascual, CPC-A Jason Rucker, CPC-A Jawanna Richardson, CPC-A Jaya Dharmaraj, CPC-A Jaya Venkat Angilika, CPC-A Jayanthi Balasubramaniyan, CPC-A Jaymee Steffen, CPC-A Jaymi Stokes, CPC-A Jaymie Tagudar Andrada, CPC-A Jean Stiteler, CPC-A Jeannie Noguchi, CPC-A Jeesa Stephen, CPC-A Jeffrey Zuniga, CPC-A Jenae Rethmeier, CPC-A Jenan Dharmatheerthan, CPC-A Jenna Butler, CPC-A Jenna McAulay, CPC-A Jennifer Atkinson-Beal, CPC-A Jennifer Bailey McCuiston, CPC-A Jennifer Bemisdarfer, CPC-A Jennifer Burns, CPC-A Jennifer Clinedinst, CPC-A Jennifer Cook, CPC-A Jennifer Corley, CPC-A Jennifer Eslit, CPC-A Jennifer Flynn, CPC-A Jennifer Foskett, CPC-A Jennifer Hill, CPC-A Jennifer Jones, CPC-A Jennifer King-Gorman, CPC-A Jennifer Lampe, CPC-A Jennifer Lang, CPC-A Jennifer Miller, CPC-A Jennifer Moody, CPC-A Jennifer Mrzyglod, CPC-A Jennifer Murphy, CPC-A Jennifer Roush, CPC-A Jennifer Saletel, CPC-A Jennifer Tarwater, CPC-A Jennifer Topka, CPC-A Jennifer Valentine, CPC-A Jennifer Walker, COC-A Jennifer Woommavovah, CPC-A Jennifer Y Henry, CPC-A Jenny Mcdougle, CPC-A Jenny Mcginnis, CPC-A Jenny Ramdehal, CPC-A Jerigael Miranda, CPC-A Jesseca Dodd, CPC-A Jessica Amber Hyer, CPC-A Jessica Barros, CPC-A Jessica Diaz, CPC-A Jessica Evenson, CPC-A Jessica Ewing, CPC-A Jessica Garza, CPC-A Jessica Gibby, CPC-A Jessica Hinskey, CPC-A Jessica Johnson, CPC-A Jessica Lynn Burnham, CPC-A Jessica Tarbet, COC-A Jessie Carrick, CPC-A Jhansi Jampareddy, COC-A Jill Colleen E. Bitas, CPC-A Jill Elizabeth Esposito, CPC-A Jillian Smith, CPC-A Jinto Paul, CPC-A Jitendra Tidke, CPC-A Joan Jessica Diego, CPC-A Joan Slater, CPC-A Joan Watanabe, CPC-A Joanhnie Castaneda, CPC-A Joanna Shelton, CPC-A Joanne Cooper, CPC-A Joben Domingo, CPC-A Jodi Johnston, CPC-A Joe Abreu, CPC-A Joelle Thomas, CPC-A Johanna May Melendez Pepito, CPC-A John C Haussecker, CPC-A John Christopher San Miguel, CPC-A John Fazio, CPC-A John Matthias Oblinada Ordona, CPC-A John Morris, CPC-A John Sniedze, CPC-A John Whitehall, CPC-A Johnnie Rush, CPC-A Jordan Rheanne Steffen, CPC-A Jose Jr Ariate, CPC-A Jose Perez, CPC-A Josephine Marks, CPC-A Joyce Porter, CPC-A Joyce Spain, CPC-A Juana Escalera, CPC-A Jubeena K.Y, CPC-A Judy Roden, CPC-A, CPB Judy Sweeney, CPC-A Juli Palmer, CPC-A Julia Ann Shonka, CPC-A Julia Boltz, CPC-A Julie Baker, CPC-A Justine Jones, CPC-A Kahley Scott, CPC-A Kara-Grace Higginbotham, CPC-A Karan Gupta, CPC-A Karantarat Kimyuan, CPC-A Karen Reeves, CPC-A Karen Ireland, CPC-A Karen M Lewis, COC-A, CPC-A Karen Martin, CPC-A Karen Wynkoop, CPC-A Kasey Deason, CPC-A Kate Gosselin, CPC-A Kate McGuigan, CPC-A Katherine Hill, CPC-A Katherine Nielsen, CPC-A Kathleen A Adams, CPC-A Kathleen Tessman, CPC-A Kathryn Derat, CPC-A Kathryn Duke, CPC-A, CPC-P-A, CPB Kathryn Elizabeth Blanchette, CPC-A Kathryn McLin, CPC-A Kathy Tilley, CPC-A Katie Bekkering, CPC-A Katie Brizendine, CPC-A Katie Sellingham, CPC-A Katlynn Alvarez, CPC-A Katrina Borden, CPC-A Katy Hegg, CPC-A Kavikuil Boopathy, COC-A Kay Gordon, COC-A Kayla Claiborne, CPC-A Kazzandra Valdez, CPC-A Keerthana Thirumalbabu, CPC-A Keerthipriya Kondamudi, CPC-A Keila Nieves, CPC-A Kelly Ann Howley, CPC-A Kelly DePardo, CPC-A Kelly Lewis, CPC-A Kelly Mastin, CPC-A Kelly Royal, CPC-A Kelly Savoie, CPC-A Kelly T Burger, CPC-A Kelly Woolford, CPC-A Kelsey Nicole Ohlinger, CPC-A Kelsi Bakker, CPC-A Kendra Fugitt, CPC-A Kendria Wolfe, CPC-A Kenneth Sharp, CPC-A Kenny Blake, CPC-A Kenny Nave, CPC-A Kenny Valdez, CPC-A Keriann Dooley, CPC-A Kerry Cloutier, CPC-A Kevin Phillips, CPC-A Kevin Thompson, CPC-A Kiana Woodruff, CPC-A Kiara Green, COC-A Kim Hinson, CPC-A Kim Keck, CPC-A Kim Storey, CPC-A Kim Wright, CPC-A Kimber Boman, CPC-A Kimberly Anderson, CPC-A Kimberly Anderson, CPC-A Kimberly Eggleston, CPC-A Kimberly F O Connor, CPC-A Kimberly Fickes, CPC-A Kimberly Fortune, CPC-A Kimberly Kruzel, CPC-A Kimberly Martin, CPC-A Kimberly Perillo, CPC-A Kimberly Reynolds, CPC-A Kimberly Ross, CPC-A Kimberly Watson, CPC-A Kira Sanders, CPC-A Kiyona Garrett, CPC-A Kris Marie Peterson, CPC-A Kris Smith, CPC-A Kriska Duff Villegas, CPC-A Kristen M Rusinovich, CPC-A Kristen Oconnell, CPC-A Kristen Schreifels, CPC-A Kristen Silvay, CPC-A Kristen Siperek, CPC-A Kristie Pavlovich, CPC-A Kristina Fletcher, CPC-A Kristine Y Hernandez, CPC-A Kristyn Forsyth, COC-A Lacey Duncan, CPC-A Laneil Nadalena Nakai, CPC-A Laquisha Julius, CPC-A Laura Baumgardner, CPC-A Laura Goffredo, CPC-A Laura Ridlespurge, CPC-A Lauren Kate Saunders, CPC-A Lauren Lucchese, CPC-A Laurie Lammers, CPC-A Laurie Rockwell, CPC-A Lauryn Crossan, CPC-A Lavanya Narayanankutty, COC-A Lawrence Spaid Jr, CPC-A Leah Ayezza Cerdeña Villafuerte, CPC-A Lee D Horrighs, CPC-A LeeAnn Walker, CPC-A Leena Margaret Johnson, CPC-A Leigh Campbell, CPC-A Leigh Yen Manlutac, CPC-A Leslie Young, CPC-A Lexi Allembaugh, CPC-A Lijo Kanjirathamkunnel Joseph, COC-A Liliana Alvarez, CPC-A Linda Barnes, CPC-A Linda Boualaphanh, CPC-A Linda Glover, CPC-A Linda Riley, CPC-A Lindsay Gillespie Hitt, CPC-A Lindsay Sandlin, CPC-A Linzi Davis Wilson, CPC-A Lisa A Zajac, CPC-A Lisa Anastas, CPC-A Lisa Caddell, CPC-A Lisa Florez, CPC-A Lisa Harvey, CPC-A Lisa Lucas, CPC-A Lisa Molt, CPC-A Lisa Nokelby, CPC-A Lisa Ruettinger RN, CPC-A Lisa Sheffer, CPC-A Lisa Stacey, CPC-A Lisa Torres, CPC-A Lisa Ybarra, CPC-A Lorelei Medved, CPC-A Lori Ann Laabs, CPC-A Lori Fohl, CPC-A Lori M Anton, CPC-A Lorie Hodges, CPC-A Lovely Guinto, CPC-A Lucille Mannino, CPC-A Lynne Berla, CPC-A Lynne DeAngelis, CPC-A Lynnette Kay Pritchett, CPC-P-A M Kalyani, COC-A Ma. Lourdes Borja, CPC-A Madhavi Kuchala, COC-A Madison N Johnson, CPC-A Maharsi Sabyasachi Jena, CPC-A Mai Chee Vang, CPC-A Maika Lor, CPC-A Malathi Gudivada, CPC-A Mallikarjuna Rao P, COC-A Mallory Yelsik, CPC-A, CUC Mamina Sahoo, COC-A Manjiri Mhatre, CPC-A Manukonda Anjali, COC-A Marchere Smith, CPC-A Marcia Epley, CPC-A Margaret Aileen Castillo, CPC-A Margaret dasilva, CPC-A Margaret Harris, CPC-A Margaret Hodges, CPC-A Margaret Laystrom, CPC-A Margaret Tan, CPC-A Margo Wikiera, CPC-A Mari Pena, CPC-A Maria A Borneman, CPC-A Maria Charidel Ty, CPC-A Maria Demo, CPC-A Maria Hand, CPC-A Maria Jenina Marzan, CPC-A MariaJose Portilla, CPC-A Mariana Mercado-Sotolongo, CPC-A Marie Alonzo, CPC-A Marie Marin-Pierre, CPC-A Mariela Justo, CPC-A Marilyn Medley, CPC-A Mariola Ampaya, CPC-A Marion Lacanilao-Tan, CPC-A Marjorie Broich, CPC-A Mark Butler, CPC-A Marlene Rubio, CPC-A Marquita Shoulders, CPC-A Martha Stewart, CPC-A Mary Alice Wilson, CPC-A Mary Anne Della Santa, CPC-A Mary Baker, CPC-A Mary Barrineau, CPC-A Mary Drahota, CPC-A Mary Eva Salisbury, COC-A Mary Faulkner, CPC-A Mary Hussey, CPC-A Mary Johnson, CPC-A Mary Mimms, CPC-A Mary Roland, COC-A, CPC-A Mary Unrue, CPC-A, CEDC Marykay Stein, COC-A, CPC-A Md. Khaja Mujeebuddin, CPC-A Mee Hwang, CPC-A Megan Donckers, CPC-A Megan Hylton, CPC-A Megan Koepke, COC-A Megan McNalley, CPC-A Meghan Gatlin, CPC-A Meghan Mae Rudd, CPC-A Mekala Rajamani, CPC-A Melanie Omer, CPC-A Melina Carson, CPC-A Melinda Kuenstler, CPC-A Melinda Mahieu, CPC-A Melissa Bausch, CPC-A Melissa Davey, CPC-A Melissa Gates, CPC-A Melissa Gillen, COC-A Melissa Kasloski-Osorto, CPC-A Melissa Kerwin, CPC-A Melissa M Silva, CPC-A Melissa Torres, CPC-A Melissa Tuite, CPC-A Merjim Macawile, CPC-P-A Merry Zerlaut, CPC-A Mia Rodelle Marie Samia, CPC-A Michael Booth, CPC-A Michael Fernandez, CPC-A Michael Ferns, CPC-A Michael Giannizzero, CPC-A 62 Healthcare Business Monthly

63 NEWLY CREDENTIALED MEMBERS Michele Adams, COC-A Michele Lykes, CPC-A Michele McClure, CPC-A Michele Sampson, CPC-A Michelle Bryant, CPC-A Michelle Causey, CPC-A Michelle Chiles, CPC-A Michelle Gauron, CPC-A Michelle Lauer, CPC-A Michelle Lynn Vienhaus, CPC-A Michelle Paustian, CPC-A Michelle Pope, CPC-A Michelle Purdum, CPC-A Michelle Raborn, CPC-A Miguel Beltre-Camilo, CPC-A Mileydis Ortega, CPC-A Minukuri Supraja, CPC-A Miriam Garcia, CPC-A Misty Madruga, COC-A Mital Thakkar, CPC-A Mohammad Asad, CPC-A Mohammed Raheem, CPC-A Mohana Ranga Pavan Kumar Gajula, COC-A Mohanapriya Pushparaj, CPC-A Molly Bolton, CPC-A Molly Nelson, CPC-A Molly Smith, CPC-A Mona Wiley, COC-A Monica Cupp, CPC-A Monique Thiessen, CPC-A Morgan Wingo, CPC-A Mriyam Lazarus, CPC-A Mylene Tabat, CPC-A Nadhiya Narayanan, COC-A Nagalakshmi Raguraman, CPC-A Nagaraju Seerapu, COC-A Nagasasikanth Mopuri, CPC-A Najat Khoury, CPC-A Nakai Kanoyangwa, CPC-A Namita Chadha, CPC-A Nancy Bennett, CPC-A Nancy Pitts, CPC-A Nancy Potaski, CPC-A Nanda Kumar Narasimha Rao, CPC-A Nani Babu, COC-A Narmadha Balaraman, CPC-A Natalia Dore, CPC-A Natalie Crockett, CPC-A Natalie Herrera, CPC-A, COBGC Natalie Ortiz, CPC-A Natalie Unrein, CPC-A Nathalie Thonethongthip, CPC-A Nathiya Palani, CPC-A Nayan Pandurang, CPC-A Nazi Munnisa Shaik, COC-A Neha Vijay Waim, CPC-A Nellie Nieves, CPC-A Nelson Torres, CPC-A Nena Shaw, CPC-A Nicole Fitzsimmons, CPC-A Nicole Trostle, CPC-A Nicole Walker, CPC-A Niesha Miller, CPC-A Niku Kumar Pandey, CPC-A Nittin Kumar Singh, COC-A Nora Hooper, CPC-A Nundye Ogor, CPC-A Nune Avanesyan, CPC-A Nusrath Farhath, CPC-A Obianuju Obiekwe, CPC-A Oi Chan, CPC-A Okeel Prasad Yadav, CPC-A Olga Marichal, CPC-A Olivia Alford, CPC-A Olivia Laycook, CPC-A Omozee Uwaifo, CPC-A Pallavi Patnam Ramireddy, CPC-A Pamela Baach, CPC-A Pamela Barker, CPC-A Pamela D Squyres, CPC-A Pamela De Chavez, CPC-A Pamela Gray, CPC-A Paola MacCallum, COC-A, CPB Papanna Thappeta, CPC-A Parimala Vadapalli, COC-A Parthasarathi Yadav, COC-A Parthiban Dakshinamoorthy, COC-A, CPC-A Patrice Edwards, CPC-A Patricia Cramer, CPC-A Patricia Jo Perez, CPC-A Patricia Lamb, CPC-A Patricia Major, CPC-A Patricia Martin, CPC-A Patricia McLaughlin, COC-A Patricia Ollila, CPC-A Patricia VanScoy, CPC-A Patricia Wheeler, CPC-A Patti Fuhrer, CPC-A Patty Pratt Kenney, CPC-A Paul Alberque, CPC-A Paul Mark Tubal, CPC-A Paul Miller, CPC-A Paula Lincoln, CPC-A Paula Lowe, CPC-A Paulina Davis, CPC-A Peggy Karraker, CPC-A Penny Mccraw, CPC-A Penny Wilkinson, CPC-A Pepper Burkholder, CPC-A Periketi Prashanth Kumar, COC-A Phil McMillan, CPC-A Philip DiFabio, CPC-A Phyllis Baron, CPC-A Pradeep Thumburu, CPC-A Prajakta Karande, CPC-A Pranay Gundawar, CPC-A Prashant Bharat Shinde, CPC-A Prasobh.R.P., COC-A Pratik R Pakhare, COC-A Praveen Patel, CPC-A Pravina Gopal, COC-A Priscilla M Carrig, CPC-A Priya Abhilash, COC-A Priya Choudhary, CPC-A Priyanka Sharma, COC-A Pushkar Bakshi, CPC-A Putta Venkata Ravikumar, COC-A Rabiyathul Ramzan Amanullah, CPC-A Rachael Lopez, CPC-A Rachel Hayes, CPC-A Rachel Rose, CPC-A Rachel Swanson, COC-A Rachel Wilhelm, CPC-A Rachel Williams, CPC-A Rachel Woods Simmons, CPC-A Radha Selvam, CPC-A Radhika Balu, COC-A Rafiqua Nasreen Ahmed, COC-A Raghu Thota, CPC-A Rajesh Kalaka, CPC-A Rajesh Kumar Y, COC-A Rajeshwari Mohan, CPC-A Rajitha Mannem, COC-A Ralena Tilman, CPC-A Ramana Chinthalapalli, CPC-A Ramesh Inturu, COC-A Ramreddy Gade, COC-A Raquel Rios, CPC-A Rashmi Arun Rane, CPC-A RashmiRanjan Mallick, COC-A Ravi Dwivedi, CPC-A Ravi teja Thodupunoori, CPC-A Ravivarman Thirunavukkarsasu, CPC-A Rayshel Moredo Calimquim, CPC-A Rebeca Martinez, CPC-A Rebecca Ash, CPC-A Rebecca Hershey, CPC-A Rebecca Perando, CPC-A Rebecca Reed, CPC-A Rebecca Stone, CPC-A Reena Mathew, COC-A Reenu Sukumaran, COC-A Renee Kirkland, CPC-A Renita Ulrich, CPC-A Resmi Ann Chakkalakal, CPC-A Revathi Selvaraj, CPC-A Rhonda Ceron, CPC-A Rhonda Cottom, CPC-A Rhonda Ratcliff, CPC-A Ria Rosario Bustamante, CPC-A Riaa Narayan, CPC-A Richard de Keyser, CPC-A Riley Schmitt, CPC-A Robbie Blount, CPC-A Roberta Jaramillo, CPC-A Robin Bretey, CPC-A Robin Davis, CPC-A Robyn Craig, CPC-A Rodolfo Hernandez, COC-A Rohit Sachdeva, CPC-A Rohit Vitthalrao Jadhav, CPC-A Rohith Yammaji, COC-A Romina Hillier, CPC-A Rosanna Montague, CPC-A Rosemary Cintron, CPC-A Ross Putterman, CPC-A Roxanne Montford, CPC-A Roxanne Weller, CPC-A Rufannie Abanto, CPC-A Ruth Ann Doering, CPC-A Ryan Philbrook, CPC-A Sabeen Rehman, CPC-A Sabita Mishal, COC-A Sabrina Lewis, CPC-A Sachin Kumar, COC-A Sadanand Sundaragiri, CPC-A Sadhana Poloju, COC-A Sahili Sanjay Sawant, CPC-A Saibabu Chalapaka, COC-A Samantha Ray, CPC-A Samantha Saenz, CPC-A Samantha Traylor, CPC-A Sameer Khan, CPC-A Sameer Phadtare, CPC-A Sandhya Belli, COC-A Sandhya Gardi, CPC-A Sandhyarani Deeti, COC-A Sandra Margarita Lazo, CPC-A Sandra Petersen, CPC-A Sandra Young, CPC-A Sandy Blowers, CPC-A Sandy Robinson, CPC-A Sangeeta Patil, CPC-A Sangeetha Ashokkumar, COC-A Sangeetharajan Balu, COC-A Sanjay Jha, CPC-A Sara Jenkins, CPC-A Sara Lamb, CPC-A Sara Naegele, CPC-A Sara Waymire, CPC-A Sarah Jennische, CPC-A Sarah Moschner, CPC-A Sarah Neary, CPC-A Sarah Snow, CPC-A Sarah Wood Rodriquez, CPC-A Saranraj Ravi, COC-A Saritha Sanapally, CPC-A Sashine Rivera, CPC-A Satheesh Kumar, COC-A Satish Sharma, CPC-A Satyarekha Vishwakarma, CPC-A Satybhan Singh, CPC-A Savanna Powers, CPC-A Sayyad Alam, CPC-A Selma Cokic, CPC-A Selvan T, CPC-A Sena Chavez, CPC-A Shaheda Taher, CPC-A Shalae Patrick, CPC-A Shanique Garvin-Green, CPC-A Shannon Lawton, CPC-A Sharel Monteiro, CPC-A Shari Michaels, COC-A Shari Sharrock, CPC-A Shari Singh, CPC-A Sharleta Vochoska, CPC-A Sharon E Potts, CPC-A Sharon Hilderbrand, CPC-A Sharon Lucas, CPC-A Sharon Wykoff, CPC-A Shashi Shekhar, CPC-A Sheena Hart, CPC-A Sheila Curtis, CPC-A Sheila Yvette Lugo Donis, CPC-A Sheila Zaner, CPC-A Shelbi Traylor, CPC-A Shelby Cooper, CPC-A Shelby Walker, CPC-A Shelley Richard, CPC-A Shellie Ericson, CPC-A Shelly Alexander, CPC-A Shelly Broeker, CPC-A Shelly Dorton, CPC-A Sheri Hansen, CPC-A Sherilyn Quimpo, CPC-A Sherry Calarco, CPC-A Sherry Sidebothom, CPC-A Sheryl Garcia, CPC-A Sheryn Burger, CPC-A Shibin Thomas Denny, CPC-A Shirley Duran, CPC-A Shirlyn Sahim, CPC-A Shiva Kumar Margam, COC-A Shruthi Nannapuraj, CPC-A Shruti Chaurasia, CPC-A Shubhangi Sonker, CPC-A Siji Thankathurai, CPC-A Sincerely Pagobo, CPC-A Sindhura Valluru, COC-A Sivaram Prasad Adi Reddy, CPC-A Smitha Rajkumar, COC-A Sonia Zelaya, CPC-A Sophia Trout, CPC-A Soumya Ranjan Sahoo, COC-A Sravani Boosipalli, CPC-A Sravanthi M, CPC-A Sreehari Koppavarapu, COC-A Sreelekha Yerram, CPC-A Sriharsha Bugude, CPC-A Srikanth Yegurla, COC-A Srinivasan R, COC-A Srinivasan Subramanian, CPC-A Sriranjani Valluri, COC-A Stacey Dunlap, CPC-A Stacey Howlan, CPC-A Stacey Stowers, CPC-A Stacy Hall, CPC-A Stacy Whelchel, CPC-A Steeven Sumulong, CPC-A Stephani Cox, CPC-A Stephanie Anderson, COC-A Stephanie Anne Campbell, CPC-A Stephanie Conn, CPC-A Stephanie Davis, CPC-A Stephanie Harris, CPC-A, CPB Stephanie Pittenger, CPC-A Stephanie Wedo, CPC-A Suchita Anil Pawar, CPC-A Sue Witter, CPC-A Suheily Claudio Fontanez, CPC-A Suman Kumar Katiki, COC-A Sumerta Ochani, CPC-A Surbhi Sharma, CPC-A Surendar Angothu, CPC-A Surender Yadav., CPC-A Surendra Sisodiya, CPC-A Suresh Kumar Reddy, COC-A Suresh M K, CPC-A Suresh Pendikatla, COC-A Sureshkumar Sayam, COC-A Sureshkumar Sayam, COC-A Susan Volkman, COC-A Susan Carlson, CPC-A Susan Delia, CPC-A Susan Evans, CPC-A Susan Meyer, COC-A Susan Raso, CPC-A Susan Saunders Frye, CPC-A Susana Torralba, CPC-A Susanna Kirksey, CPC-A Suzanne Caldwell, CPC-A Suzanne Gonzalez, CPC-A Suzanne Morris, CPC-A Suzanne Wiemar, CPC-A Suzette Lambert, CPC-A Swetha Surukanti, CPC-A Sylwia Wiatr, CPC-A Tabitha Hodges, CPC-A Takrista Momon, COC-A Tamara Detillo, CPC-A Tamara Harris, CPC-A Tamara Rochholz, CPC-A Tammy Beglau-Lopez, CPC-A Tammy Earley, CPC-A Tammy Saul, CPC-A Tammy Siraguso, CPC-A Tammy Wells, CPC-A Tammy Wendinger, CPC-A Tanis Rodriguez, CPC-A Tanisha Abraham, CPC-A Tanuj Kumar, CPC-A Tanya Davis, CPC-A Tanya Hasslbauer, CPC-A Tanya Ortega, CPC-A Tara Chatham, CPC-A Tatjana Mrkic, CPC-A Tejaswi Mahadik, CPC-A Tena Wiese, CPC-A Tera Freeman, CPC-P-A Teresa Draheim, CPC-A Teresa Hensley, CPC-A Terri Bacon, CPC-A Terri Schenkel, CPC-A Thamizhchelvi Muthaiyan, CPC-A Thenammai Nachiappan, CPC-A Theresa N Holloway, CPC-A Theresa Speer, CPC-A Thomas E Bentz, CPC-A Thomas Golden, CPC-A Thota Suneeta, CPC-A Thuvan Masson, CPC-A Tiffany Davis, CPC-A Tiffany Reardon, CPC-A Tiffany Rogers, COC-A Tiffiny Ewan, CPC-A Tilda Bovenzi, CPC-A Timong Wani, CPC-A Timothy Barreca, CPC-A Tina Sternberg, CPC-A Todd Becker, CPC-A Toni Irwin, CPC-A Toni Timms, CPC-A Tracey Campbell, CPC-A Tracey Hayes, CPC-A Tracey Mangum, CPC-A Tracey Smith, CPC-A Traci Crossley, CPC-A Tracy Abeyta, CPC-A February

64 NEWLY CREDENTIALED MEMBERS Tracy King, CPC-A Tracy Medeiros, CPC-A Tracy Read, CPC-A Tracy Wilcom, CPC-A Tricia Barrett, CPC-A Tricia Rudisill, CPC-A Trina Springer, CPC-A Tushar Ramesh Patil, CPC-A Ueatawan Raleigh, CPC-A Ulani Woodard, CPC-A Umarani Nalla, COC-A Vaishali D Shetty, CPC-A Vemuri Manjusha, COC-A Vengala Nikhil Kumar, COC-A Venita Aualini, CPC-A Venkatakullaisetty Nukala, COC-A Venkatesh Tallari, CPC-A Verma Vivek, CPC-A Vernita Hultman, CPC-A Vibha Bodake, CPC-A Vicki Bayrouty, CPC-A Victoria A Forsell, CPC-A Victoria Bauco, CPC-A Victoria Roberts, CPC-A Vidhyakumari R S, COC-A Vigneshbalkrishna Amin, CPC-A Vijaya Simhan Mohan, COC-A Vijayalaxmi Iyer, CPC-A Vijendra Singh, CPC-A Vikas Jaiswal, CPC-A Vikash Mani, CPC-A Vikash Prakash, COC-A, CPC-A Viktoria Anna McAdams, CPC-A Vilma Berzonskis, CPC-A Vinay Kumari S, CPC-A Vinod Kumar, CPC-A Vipin Kumar, CPC-A Vishal Bhardwaj, COC-A Vishal Matlotia, COC-A Wanda Wilcox, CPC-A Wendy Doles, CPC-A Wendy Whitaker, CPC-A Whitney Noe, CPC-A Whitney Smith, CPC-A William Nall-Cain, CPC-A William Stradley, CPC-A Xee Xiong, CPC-A Yaimaime Ruiz, CPC-A Yashica Robinson, CPC-A Yenise Oms, CPC-A Yogesh Kadyan, COC-A Yolanda Babin, CPC-A Zahri Kahoor Umid, CPC-A Zann Travis, CPC-A Zsuzsanna Fine, CPC-A Specialties Abbie Torigoe, CPC-A, CPB Abhijeet Kanmande, CIC Abigail Italia Hernandez, CPC, CRC Adeana Shoemaker, CPC-A, CPB Adele Miyasato, CPC, CPMA, CEDC, CEMC Adina Heller, COC, CPC, CRC Adriana Beltran, CPC, CRC Aimee Heckman, CPB, CPPM Aimee M Snead, CPC, CPMA Ajamarie Burns, CPB Akanksha Anandbhai Patel, CRC Alaina Bradshaw, COC, CPC, CPMA Aleida Araujo, CPB Alicia Espinosa, CPC-A, CRC Alicia Huffine, CPCD Alicia S Jones, COC, CPC, CRC Alison Chase, CRC Allison Disessa, CPC, CPMA Allissea Lunsford, CPC, CEDC Alysia Minott, CIRCC Amanda C Fetscher, CPC, CRC Amanda C Turner, CPC, CPB, CRC Amanda Chen, CPC, CPMA, CEMC Amanda Goins-Hill, CPC, CRC Amanda M Leavy, CPB Amy Hrivnak, CPC, CPMA, CRC Amy L Potter, CPC, CPMA Amy Love, CPC, CPC-P, CPMA, COBGC Ana Armstrong, CPC, CPMA Anas Waquar, COC-A, CIC Andrea Dawson, CPC, CPB Andrea Qualls, CPC-A, CRC Andrea ReNee Moss, CPC, CCC, CEMC Andrea Riggs, CPC, CPMA, CEMC Andrew Perring, CPC-A, CRC Angel Skoglund, COC-A, CPC-A, CRC Angelique Acosta, CPC-A, CGSC Angelique Kendall, CPC, CRC Anita Kathleen Martinez, CPC, CPPM Anita M Johnson, CPC, CPMA, CGSC, CRC Anjali Katiyar, CIC Anne Hillmann, CPC, CPMA Anne Hodges, CPPM Anne Marie Holmes-Cahill, CPC, CPMA Anne Tuck, CRC Antoinvette Sinclair, CPC, CEMC, CIMC Anusha Nadukuru, CIC Ashley Fryberger, CPC, CPMA Ashley M Fry, COC, CRC Asif Abduljabbar Meman, CRC Balaji Anna Balaraman, CPC, CRC Balraju Cherla, CIC Barbara Ann Myers, CPC, CGSC Barbara C Rodriguez, CPC, CRC Barbara Metallo, COC, CRC Beata Lidia Wolanski, CPC, COBGC Becky Taylor, CPB Belinda McCoy, CPC, CPPM Bernadette Sanedrin, CIC Beth Schleeper, CPC, CPCO, CPB, CPMA, CPPM, CPC-I, CEMC Bethany D Ammeson, CPC, CPMA Beverley Sambor, CPC, CPMA Bharti Smith, CPB Bhumi Dineshbhai Patel, CRC Billie Sunderland, CPC, CANPC Bobbi Garlow, CPC, COSC Bradley D Miller, CPC, CPC-I, CRC Brandy Harris, CPC, CPCD Brandy Julian, CPC, CRC Brandy R Cordova, CPC, CANPC Brandy Russell, COBGC Brenda J Ozimek, COC, CPC, CPMA, CHONC Brenda Louise Bomberger, COC, CPC, CRC Brenda R Stevens, CPC, CPMA, CRC Brenda Rahn, CPC, CRC Bridget Turner, CPC, CRC Candice Liu, CPC, CIRCC Candice McAuliffe, CRC Candice Williams, CPC, CRC Candy Lee Levering, CPC, CEDC Cara Leann Dyehouse, CPC, CRC Carmen Martinez, CPC, CEMC, COSC, CSFAC Carol A Miller, CPB Carol Ermis, CPC, COSC Carol Keeney, CPC, CEMC Carol Neil, CPC, COSC Carole L Clark, CPC, CPC-I, CIC Carolina J Iturralde, CPC, CPMA, CEDC, CEMC Carolyn S Shankle, COC, CPC, CPB, CPMA, CPC-I, CEMC Carolyn S White, CPC, CPMA, CCC, CGSC, COSC, CRC, CUC Carrie Elizabeth Gillard, CPC, CEDC Cassandra Marie Romero, CPC, CPMA, CPPM, CEMC Catherine A Hagen, CPC, CPMA, CEMC, CIMC Catherine MacLaine, COC, CRC Cathleen Plaza, CRC Cathlene Dietz, COBGC Cecilia L Forde, COC, CPC, CPMA Celeste T Darnell, CPC, CPMA Ceola Strahler, CPMA, CEMC Chakravarthi Gandepalli, CIC Chander Bhan, CPC-A, CIC Chanel Joseph, CPC, CPMA, CRC Charissa Woodruff, CRC Charity Brown, CPC, CEMC Charity Green, CPC, COBGC Charleen Remedios, CPC, CPMA Charlene Catalanotto, CPC, CEDC Charles Vincent, CIC Charugundla Meenakshi, CIC Chaundra Dickinson, CPC, CRC Cheryl Bohn, CPMA Chiquina D Williams, CPC, CPMA, CRC Chiranjeevi Jada, CIC Chitranjan Jaiswal, CIC Chris Cranor, CPC, CPCO, CPPM Chris Drevers, CPC, CPMA Christina Johnson, CPC, CPB Christina Llampay-Medina, CPC, CPB, CPMA Christine Burke, CIC Christine Mary Madeya, CPC, CRC Christine Olivas, CPC, CPMA Christine Perry, CPC, CPMA Christine Thompson Harris, CPC, CPMA Christine Yee, CPB Cindi Marantz Kline, CPC, CPMA, COBGC Cindy Roberts, CPC, CPMA, CPCD, CPRC Cindy Steele, CRC Clare M Uhler, CPC, CPMA, CPC-I, CRC Clorinda Duran, CPC, CRC Colette Bernard, CPC, CPMA Connie Altman, CPC, CRC Coumba Sam Diallo, CPC, CPPM Courtneay Lynn Carter, CPC, CEMC Cynthia R. King, CRC Cynthia Ackiss, CPC, CPMA Cynthia Gonthier, COC, CPC, CPMA Cynthia Gougian, CPC-A, CRC Cynthia K Powell, CPC, CRC Cynthia L Kazda-Horvack, CPC, COBGC Cynthia Stephenson, CPC, CRC Cynthia Stringfellow, CPC, CPB D Sateesh, COC-A, CIC Dana D Wells-Gomez, CPC, CPMA Dana J Proctor, CPC, CRC Dana Jones, CPC, CPMA Dana Marie Clemmer, CPC, CANPC Dana Michel, CPC, CRC Danielle C Michener, CPC, CHONC Danielle Pavao, CPC, CPB Darla LaFont-Matis, CPC, CEMC Darlene M Alvarez, CPC, CRC David Hadley, CRC Davina Ikponmwosa, CRC Dawn Catanese, COC, CPC, CRC Dawn Marie Lagmay Gabriel, CPC, CPMA Dawn Marie Nickens, CPC, CPMA Dawn Taylor, CPB Dayna Ann Heine, COC, CPC, CPB Deb Ranjan Sarkar, CPC-A, CIC Debbie Adams, CPC, CPMA, CEMC Deborah Cochran, CPC-A, CPB Deborah E Palmer, CPC, CRC Deborah K Price, CPC, CRC Dedra Fillman, CPC, CPMA Dee Fullilove, CPC, CGSC Delores M Kerber, CPC, CRC Demetria Bonner Woodson, CPC, CPB, CRC Denise Leturgey, CGIC Denise Parker, COC-A, CPC-A, CPB Dharmishtha Narsinhbhai Prajapati, CRC Dhaval P. Thakkar, CRC Diana Oruci Adams, CPC, CPMA Diana Wenrich, CPC, CPB Diane Joyce Andrews, CPC, CEDC Dianelis Macaya Perez, CPC, CRC Donna Fazio, CPC, CCC Donnine E Day, CPC, CPMA, CENTC Doreth Vanassa Campbell, CPC, CPMA Dorothy R McClure, CPC, CPPM Dorrett Elder, CRC EdithAnn M Faoro, CPC, CPMA, CRC Edward Townley, CPC, CPC-I, CEMC Eileen Stein, CPC, CRC Elaine I Thompson, CPC, CPMA Elaine M Falcetti, CPC, CANPC Elijah Burton, CPC-A, CPB Ellen Marie Sliger, CPC, CPMA Elvis Oduware Jackson, CPC, CPPM Emily G Fadri, CPC, CRC Enosh Kevin Tadikonda, CIC Erica Tyler, CPC, COSC Erick Downs, CPC, CPMA Erin Kuhr, CPC, CRC Everett Bernier, CPC-A, CRC Faye Feliciano, CPB Felicity Farmer, CPC, CRC G S Kanchana, CIC Gabriel R. Aponte, COC, CPC, CPMA, CCC, CHONC, CIC, CRC Gail Grabinski, CPC, COSC Gail J Ragan, COC, CPC, CPMA Galyna Pecherska, CPC, CRC Geetha Velpula, CIC Georgina Youssef, CPB Gina LeBlanc, CPB Gina Patricia Holdorff, COC, CPC, CPCO, CPC-P, CPB, CPMA, CASCC, CEDC, CHONC, CRC Glenda Mattonen, CPC, COBGC Gloria Chiapetta, CPC, CRC Guruvaiah Palepogu, CIC H. Diana Wyss, CPC, CCC Hardik Bharatbhai Dani, CRC Harikrushna Ragolu, CIC Hazel Yuhas, CPC, CPB Heather Ann Curtis, CPC, CPMA Heather Lyn Clifton, CPC, CPCO Heather TyLynn Smolinski, CPC, CPMA Heidi A Stewart, COC, CPC, CPMA, CEDC, CEMC Helen Burkshire, CPC, CRC Hilary K. Lopez, CPC, CPMA Hiroe Derhake, CPB, CRHC Hitendrasinh Vaghela, CRC Holly Brown, COC, CPC, CPCO, CEMC Holly Tidd, CPC, CEMC, CIMC Ignatia J Agus, COC, CPC, CPMA, CCC Ilona Kalisky, CPC, CPMA Jacque Lynette Weaver, CPC, CPMA Jacqueline M Rich, CPC, CPB Jacqueline Pethel, CIRCC Jacqueline Rose Pagan, CPC, CIC Jagadeesh Kulkarni, CIC Jaime McCoy, CPC, CHONC James Blue, CPC, CPB, CPPM Jami S Spears RN, CPC, CPMA Jamie Claypool, CPC, CPMA Jan Ingham, CPC, CPMA, CEMC Jan Thompson, CPB Jana M Harrison, COC, CPC, CEDC, COBGC Jane Digeno, CPC, COSC Janel Joseph, CPC, CEMC Janelle Marie Quick, CPC, CPCO, CGSC Janelle Thibodeau, CPC, CPPM Janet Muskardin, CPB Janet V Salemno, CPB Janet White, CPPM Janet Wood, CPC, CRC Janet Yvette Blair, CPC, CRC Janice Lynn Kenney, CGIC Janice N White, Ed.M., RHIA, CMRS, CTR, CPC, CRC Janis Kuykendall, COC, CPC, CANPC, CEMC, COSC Janita L Haley, CPC, CPMA Jason Vann, CPB Jaswanthi Bandlamudi, CIC Jayapal Sudharssen, CPPM Jayne Galbraith, COC, CEDC Jean R Pryor, CPC, CPMA, CPC-I, CIMC, CRC Jeanmarie Morse, COC, CCC Jeanne S Gershman, COC, CPC, CPB, CEMC Jeffrey Johnson, CPB Jenna M. Maestas, CPC-A, CCVTC, CIMC Jennifer Boyer, CPC, CPB, CPMA, CEMC Jennifer Cline, CPPM Jennifer Davis, CIRCC Jennifer L Beaudry, CPC, CCC, CCVTC, COSC Jennifer Leigh Croft, CPC, CPB Jennifer M Connell, CPC, CPCO, CPMA, CPPM, CENTC Jennifer Maher, COC, CPC, CEMC Jennifer Norton, COC, CPC, CPMA, CEMC, COSC, CSFAC Jennifer Quintero, CPC, CRC Jennifer Rebecca Perry, CPC, CRC Jennifer Smith, CPC, CPMA Jennifer Sullivan, CRC Jenny Smith, CPC, CGSC Jerri Lynn Menz, CPC, CFPC Jessica Gosnell, CPC, CPC-I, CRC Jessica L Hall, CPC-A, CPB Jessica Lee Chandler, COC, CPC, CPC-P, CPB, CCC Jessica Onakoya, CPC-A, CPMA Jessica Williams, CPC, CPMA Jewel Blackmon, CPB Jill Brosen, CPC, CRC Joan Merlyn Pillai, CPC, CEDC, CEMC Joanne Martin, CPPM JoAnne Stephens, CPC, CPMA, COSC Joellyn Cochran, COC, CRC Jolene M Martens, COC, CPC, CPMA Jolene Riesselman, COC-A, CEDC Joleta Jones, CPC, CPMA, CEMC, COBGC Jose Fontanilla, CIC Joseph Lamm, CPC, CPMA Joyce R Petermann, CPC, CRC Jule E Hendershott, CPC, CPCO, CGSC Julia Colao, CPB Julia Nabiullina, CPC, CPCO, CPMA Julia V Brodie, CPC, CRC Julie K Clark, CPC, CPCD Julie M Smith, CPC, CIRCC Kamlesh Kant, CRC Kara Mann, CPC, CPB, CPC-I, CRC Karen Conte, CPC-A, CPB Karen D Gillespie, CPC-A, CPB Karen L Gentry, CPC, CRC Karen Lavigne, CPC, CPMA, CRC Karen M Cobb, COC, CPC, CCC Karen McArthur, CPC, CANPC, CGSC Karen V Moses, CPC, CPMA, CEMC Karen W Kelly, CPC, CPMA, CRC Karen Y Manigault, CPC, CEDC, CEMC Karena R Phillips, CPC, CIC Karina R Seghelmeble, CPC, CCC Katherine Rice, CIC 64 Healthcare Business Monthly

65 NEWLY CREDENTIALED MEMBERS Katherine Tokach, CPB Katherine Wright, CPC, CPMA Kathleen Decipulo, CPC, CRC Kathleen M Bolton, CPC, CCVTC Kathleen Moran, CPC, CRC Kathy Lynne Dawson, CPC, CPMA, CFPC Katie Hagan, CPC, CPMA Katrina Rosales, CPC, CRC Kavita Chavan, CPC, CIC Kaye Joyner, CPC-A, CPC-P-A, CPB Keicia Tamara Cornwall, COC, CPC, CPC-P, CRC Keith Maxey, CPB Kellie McGovern, CPC, CRC Kelly A Schaffer, CPC, CRC Kelly Goetz, CPC, CEDC Kelly L Rostak, CPC, CPPM Kendal Johnson, CPC, CEMC Kendra Surdam, CPC, CPB Kenrick Mui, COC, CPC, CPMA, CUC Keri Rodgers, CPC-A, CRC Kerri Romao, CPC, CRC Kerry Lopez, CPPM Kevin Karolian, COC, CPC, CPMA Kevin Kirschenmann, CPC, CPCO Khushboo Bharatsinhji Dabhi, CRC Kim Campbell, CIC Kim Joyce Martinchek, CPC, CPMA, CCC Kim Logan, COC-A, CRC Kimberley CeCille Hewitt, CPC, CPMA, CEMC Kimberly A Pohovey, CPC, CPMA Kimberly Bechtel, CPC, CRC Kimberly Cunningham, CPC, CIC Kimberly Dziekan, CPC, CPMA, CPC-I Kimberly Gartiser, CPC, COBGC Kimberly Kate Mann, CPC, CRC Kina Watson, CRC Kiplyn Gilbert, CPC, CPCO, CPMA Kirankumar Mettekadupula, CIC Kirankumar Muljibhai Parmar, CRC Kris M Coate, CPC, CRC Kristen Lynn Metzke, CPC, CGIC Kristin Ruvalcaba, CPC-A, CPB Kristina B Kahan, COC, CPC, CRC Krystal Hines, CPC, CRC Kushal Rameshchandra Thakar, CRC Kyle Williams, CPC, CPMA, CEMC, CIC L Gay Ball, CPC, CRC Laida I Solá Suárez, CPC, CRC Lana Miller, CPC, CPMA, CPCD Lanaya Sandberg, CPCO, CPPM Laura Grace Craig, CPC, CRHC Laura Smith, CPC-P, CPMA Laurie Ann Walter, CPC, CRC Leah Silva, CPC-A, CRC Leandra Tufts, CPC, CEMC, COBGC Leann Rose Ottomeyer, CPC, CPB Lee Ann Bailey, CPC, CPMA, CGSC Leidys Pardo, CPC, CPMA Leonardo Sierra, CPC, CRC Leslie Dennison, CPC-A, CPMA Letzy Yahaira Quiles, CPC, CRC Liliana Madrid, CPPM Lina Kerr, COC, CPC, CRC Lisa Ann Elswick, COC, CPC, CRC Lisa Azevedo, COC, CPC, CRC Lisa Campbell-Lyons, CPB Lisa Denise Chichester, CPC-P-A, CHONC Lisa Lea, CPC, CEMC Lisa Marie Koopmeiners, CPC, CGSC Lisa Walker, COC, CPC, CPC-I, CEMC Lori Baskin, CPC, CRC Lori Daly, CPPM Lorri E Tolliver, CPC, CPMA, CEMC, CRC Luann Bechard, CPC, CRC Ludaimmaculate Ashokraj, CPC, CIC Luz Adriana Gallon, CPC, CPMA Lynette Stachowski, CPC, CPB Lynn Zabar, CPPM Maggie McCabe, COC, CPC, CPC-P, CPB, CPC-I Manuel De Jesus Grullon, CPC, CRC Margaret Morgan, CPC, CIRCC Marguerite Anne LaBelle, CPC, CPMA Marguerite Lisa Slager, CPC, CRC Maria Chipongian, CPC, CRC Maria Lear, CIMC Maria Victoria Rogers, CPC, CRC Mariajorjina Hope Gonzales, CPC, COSC Marianne Robinson, CPC, CRC Marilyn S McCauley, CPC, CPMA, CFPC, CPEDC Marilyn Todd, CPC, CPMA, CEMC Marina Olivarez, CPC, CRC Marisol M Dalton, CPC, CRC Marjorie Vizcaya, CPEDC Mark Martinez, CPC, CPMA, CRC Marnie Frasier, CPC, CRC Marta Buxton, COC, CPC, CPMA, CUC Mary Ann Blanchard, CPC, CPMA Mary Beth Bridges, CPC, CRC Mary Kay Berry, CPC, CEMC Mary Lanigan, CPC, CPMA Mary McNaughton, CPC, CRC Mary Meadows, CPC, CRC Mary-Jo Griffith, CPC, CPC-I, CEMC, CGSC, COSC Maureen West, CPC, CHONC Melanie D Rivera, CPC, CANPC, CGSC Melanie Garcia, CPC, CGSC Melba C DeLesDernier, CPC, CPMA Melissa Anne Cotton, CPC, CRC Melissa Hall, CPC, CRC Melissa Loos, CPC, CPMA Melissa Mottley, CPC, CRC Melissa Sheeler, CPC, CRC Meredith Quinn, CPPM, CHONC, CPEDC Michael Wu, COC, CPC, CPC-P, CIRCC, CPMA, CPC-I, CANPC, CASCC, CCC, CCVTC, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIMC, COBGC, COSC, CPCD, CPEDC, CPRC, CRHC, CUC Michelle Cranney, CPC, CPB Michelle Garber, CPC, CRC Michelle M Renis, CPC, CEDC Michelle N Myrick, CPC, CPMA, CPC-I Michelle Starling Creech, CPC, CEMC MohamedSaad Hasan Veenravarthar, CIC Molly Reid, CPC, CIMC Monique Vanderhoof, CPC, CRC Muhammad Tayyab Ahmad, CPC-A, CPMA Myrsol Miciano Ceballo, CPC, CPMA Nagaraj Motalkunta, CIC Nancy Almanzar, CPC, CPMA, CRC Nancy Garcia, CPC, CPMA Nancy Genschaw, CPB Nancy Jean Ames, CPC, CPMA Nancy Kay Perry, CPC, CGSC Nancy Stephenson, CPB Naresh Rapelly, CIC Natasha Petty, CPC, CPB Nathan Monroe, COC-A, CPC-A, CPC-P-A, CPMA, CEDC, CEMC Nawanath Jadhav, CIC Netaji Ramesh Tharigoppula, CPMA Nichole J Roberts, CPC, CRC Nicole Wells, CPB Nikhil Katekam, CIC Nikki Leatherberry, CPC, CPMA, CRC Nirmala Eri, CPC, CIC Nivant Prabhakar Waghmode, CPC, CEMC Noemi Delgado, CPC, CRC Noemi Salazar, CPC, CRC Nona S Abbott, CRC Notchea N Ward, CPC, CPCO, CPMA, CEMC Pam Mentzer, CPC, CPB Paparaju Srinivas, CPC-A, CIC Pareshbhai Patel, CRC Patricia A Grote, CPC-A, CPMA, CRC Patricia A Lynch, CPC, CENTC, COBGC Patricia Anne Martinez, CPC, CRC Patricia Joyan Lee, CPC-A, CRC Patricia Skinner, CIMC Paul Young, CPC-A, CRC Paula J Lunz, CPC, CIRCC, CCC Peggy McBride, CPC, COSC, CRC Piyush Gandhi, CPC-A, CIC Pradeepa Thanthoni, COC, CRC Pramit Kumar, CPC-A, CIC Priyankaben Natubhai Patel, CRC Pushpagiri Prasanthi Karuna Kumari, CIC Rachamalla Narendhra Reddy, COC-A, CIC Rachel Pritchard, CPCO Rachel Williamson, CPB Rainier Cajulis, CRC Rajani Reddy, COC-A, CIC Rajasekhar Chakka, CIC Rajkumar Kuppuraj, CPC, CIC Raju Yatham, CIC Ramasubbu Subburayalu, COC, CPC, CPCO, CPC-P, CIRCC, CPB, CPMA, CPPM, CANPC, CASCC, CCC, CCVTC, CEDC, CENTC, CFPC, CGIC, CGSC, CHONC, CIMC, COBGC, COSC, CPCD, CPEDC, CPRC, CRC, CRHC, CSFAC, CUC Ramesh Rathod, CIC Ratish Nair, CPC-A, CIC Rayna P Calaro, CPC, CPMA, CFPC, CRC Rebecca Chicketti, CPC, CEMC, CRC Rebecca Rutherford, CPC, CPMA Regina Hoffman, CPC-A, CRC Regina Reed, CPC, CRC Renae Middleton, CPC, CPMA Renee Diaz, CPC, CPMA Rishi Joseph, CPPM Robi Stach, CPC, CRC Robin A Kuyrkendall, CPC, CRC Robin Barrow, CPC, CPMA, COBGC, CRC Robin Gulick, CPC, CPMA Robin L Plowman, CPC, CPMA, CCC, CEMC Robin Meadows, CPC, CIRCC Robyn Malejko, CPC, CPMA Roman Gontmakher, COC, CPCO Romina Brawn, CPC, CPMA Rosa A Rios, CPC, CPB Rosalie Bernardino, CRC Rosanne Hannon, CPC, CRC Roseann Eliseo, CPC, CGSC Roxanne Ruks, CPC-A, CPB Ruchi Jindal, CPC-A, CIC Russell Todd Ozmon, CPC, CPMA Sabina Seeberger Green, CPC, CCC Sachiko Hopkins, CPB Sachin Kumar, CPC-A, CIC Sadie Freerksen, CPC, CEDC, CRC Saidulu Mukkidi, COC-A, CIC Saki Bhavya, CIC Saleha Patel, CPB Sally Dougherty, CPCO Sally Ross, CPC-A, CRC Sameer Abhiman Aher, COC-A, CPC-P-A, CPB Sameer Shaik, CIC Samsuddinbhai Nabibbhai Balesaniya, CRC Sandra Drews, CPC, CRC Sandra Kim, CPC, CRC Sandra Pierce, CPC, CEMC Sandra Toland, CPC, CFPC Sangeeta Das, COC-A, CIC Santosh Kumar Meriyala, COC, CPC, CPCO, CPC-P, CPB, CPMA, CANPC, CASCC, CCC, CCVTC, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, CIC, CIMC, COBGC, COSC, CPCD, CPEDC, CPRC, CRC, CRHC, CSFAC, CUC Sara Hibbard, CPC, CEMC Sara Michelle Roberts, CPC, CPB, CEDC Sarah Clear, CPC-A, CPMA Sarah Collinson, CPC, CPMA, CEMC, CPCD, CRC Sarah Davis, CPPM Sarah Hlavinka, CPC, CPMA Sarah Schmitz, CPC, CPB Sarah Sebikari, CPC, CPCO, CRC Sari L Smith, CPC, CPMA Sasipriya Madhav, CPC, CIC Savitha Kondra, CIC Sazidhusen Mansuri, CRC Seanna Bower, COSC Shannon N Jackson, COC, CPC, CENTC, COSC Shari Wheeldon, CPC, CIRCC Sharon Faye Purnell, CPC, CPMA Sharon Hicks, CRC Sharon Mickens, CRC Sharri Anthony, CPB Shawn Gallagher, CEDC Shawna Kaufman, CPC, CIC Sheila A Wynn, CPC, CRC Sheldon Lutz, CPC, CPPM, CFPC Shelley Wilkes, CPB Shelly Peck, CRC Sherie Wilson, CPB Sherry Blea, CPB, CPPM Sherry L Wright-Fontenot, CPC, CPMA, CEDC Sheryl Williams McAdams, COC, CPC, CPCO, CPC-P, CPB Shimeka Johnson, CPCO, CPB, CPMA, CPPM Shivakrishna Nakkala, CIC Shyla M James-Neely, CRC Soibam Sotindro Singh, CPC-A, CIC Somesh Bhatt, CPC-A, CIC Srikanth Sherigudem, CIC Stacey Lynne Straz, CPC, CPMA Stacie L Jobe, CPC, CPC-P, CPMA Stacy L Diehl, CPC, CPB Stacy Lynn Ehret, CPC, CPMA, CRC Stefanie Domsky, CPC, CRC Stephanie A Hoehn, CPC, CRC Stephanie Rivera, CPC, CPMA Stephen Swisher, COC, CPC, CEDC Steve Burns, CPC, CRC Sue Aeschliman, CPC, CPMA Sunil Motopothula, CIC Sunshine Page, CPC, CPMA Suresh Babu Banda, COC-A, CIC Suresh Mathala, CIC Suresh Viswanadhapalli, CPC, CPMA Susan Hawkins, CPC-A, CPB Susan Loretta Owens, CPC, CPMA, CGSC Susan M Klokis, CPC, CEMC Susan Moran, CPC, CPMA Susan Robert Collins, CPC, CPMA, CIC Susan Sinko, CPC, CRC Suvin Badarudeen, CIC Suzanne M Baker, CPC, CPCO, CPMA, CEMC Suzanne Mary Barnes, CPC-A, CRC Swapna Jannu, CPC, CIC Swapna Mekala, CIC Swathi Pedduri, CIC Swati Joshi, CPC, CPMA, CRC Tabytha L Negri, CPC, CEMC, CGSC, COSC Talia Lee, CPC, CPMA Talitha Mitchell, CPC, CPMA, COSC Tamara Grundwalski, CPC, CPPM Tami Hemond, CPC, CPMA, CEMC Tamil Vimala, CIC Tammy Allen, CPC, CRC Tammy Comfort, CPC, CPPM Tammy Lyn Allen, CPC, CPMA Tammy S Landis, CPC, COSC Tara Murdock, CPC, CRC Tara Nicole Lance, CPC, CRC Teresa L Schubert, CPC, CPCO, CPPM Terri L Zimmerman, CPC, CPB Terri Meyer, CPC, CPMA Theresa Cook, CPC, CPMA Theresa Huber, CPB Tiana Marie Bowling, CPC, CRC Tiffany Bustle, CPPM Tiffany M Johr, CPC, CPMA Tina Elizabeth Painter, CPC, CPPM Tina Gaydosh, CPC, CEDC Tina George, CPC, COBGC Tina Lamoreaux, CEMC Tina Maple, CASCC Tina Maple, CASCC Todd Gifford, CRC Tonya Thompson Scruggs, CPC, CRC Tonya Whitlow, COSC Tracey M. Wadel, CPC, CEMC Traci Mahaffey Horst, CPC, CRC Tracie Moran, CPC, CRC Tricia Hopper-Higle, CPC, CCVTC, CIMC Tricia Lee Menard, CPC, CPMA, CRC Trisha A Achtziger, COC, CPC, CPC-P, CIRCC, CCC, CRC Umbereen Hingoro, CPC, CPB V S Kumar Peddisetti, CPC-A, CIC Valorie K Fox, CPC, CPMA Vandana Rana, CPC-A, CPMA, CEDC Vanessa Lynn Dominguez, CPC, CENTC, COSC Vanessa Utz, CPC-A, CEMC Varun Tyagi, CIC Venkateswarlu Kancharla, COC-A, CIC Venus M Jacobsen, CPB Verchera Abeita, CPC, CANPC Veronica L Manuel, CPC, CRC Vicki J Bourg, COC, CPC, CRC Vickie Lynn Bell, COC, CPC, CRC Vicky Kratzer, CPC, CGSC, CRC Victoria Ortega, CPC, CPMA, CPC-I, CIMC, CRC Vikas Chawla, CPC-A, CIC Vikash Rajbahadur Yadav, CRC Vinita Tyagi, COC, CPC, CPCO Virginia A Outlaw, CPC, CPB, CPPM, CFPC Virginia Andreozzi, CPPM Virginia Mary Foye, COBGC Vonda Ray, CPCO Wanda D Tollison, CPC, CPB, CPC-I Wanda Williams, COC, CPC, CRC Wendy A Bartko, CPC, CPCO, CPMA, CEMC, CRC Yellaswamy Parakala, CIC Yolanda Pearl Ullom, CPC, CRC Yolonda Keith, CPC, CPPM Yvonne Moncovich, CPC, CPCO, CRC Zenobia D Jean, CPC, CPMA, CRC February

66 Minute with a Member Charles Grant, CPC-A Baltimore, Maryland GOT A MINUTE? If you are an AAPC member who strives to advance the business of healthcare, we want to know about it! Please contact Michelle Dick, executive editor, at michelle.dick@aapc.com, to learn how to be featured. Tell us a little bit about how you got into coding, what you ve done during your coding career, and where you work now. I decided to change careers after years of experience as a regional transit planner for public transportation. After earning a Bachelor of Science degree in Business, it was time to consider my options. Knowing my qualifications and interest in anatomy, my wife, who is a revenue cycle manager for an area hospital, suggested I look into medical coding. I did, and I quickly decided to study the business side of medicine by way of medical coding. I enrolled in the medical coding program at a local community college and completed it in After several attempts at the Certified Professional Coder (CPC ) exam, I earned my Certified Professional Coder- Apprentice (CPC-A ) in I received my ICD-10-CM Proficiency Assessment certificate, as well. I plan to pursue the Certified Professional Compliance Officer (CPCO ) and I am also interested in being a medical coding trainer someday. What is your involvement with your local AAPC chapter? I ve been concentrating on obtaining credentials before becoming actively involved with my AAPC local chapter. Now that I m a CPC-A, I would like to take a leadership role, as well as assist exam proctors. What AAPC benefits do you like the most? There is a wealth of information on the AAPC website. Often, I get questions answered without having to call AAPC. I also enjoy the accessibility to training opportunities, upcoming events, and member discounts. How has your certification helped you? My certification has provided me with the ability to compete for various coding opportunities available in my area. It also has given me more confidence in knowing that I can succeed at this. Do you have any advice for those new to coding and/or those looking for jobs in the field? My advice is to keep studying, stay current, and never give up. What has been your biggest challenge as a coder? I have not found employment in coding yet, but I plan to continue networking for opportunities that will provide me with as much experience as possible. My local AAPC local chapter has invited me to attend meetings, training, and take advantage of networking resources. If you could do any other job, what would it be? I have experience in the areas of compliance, planning, analysis, procurement, project management, and technical assistance. Any of these areas can be applied to coding, which is what I hope to do. How do you spend your spare time? Tell us about your hobbies, family, etc. I spend my spare time helping others through counseling and mentoring. I find time to keep up on my coding skills. I like playing golf, listening to jazz, and socializing. Believe it or not, I do go to the mall with my wife I learned to like it. We attend church and I pray a lot. 66 Healthcare Business Monthly

67 Everything You Need to Get Certified Code books included: CPC COC CIC CRC CPB (excludes CPMA, CPPM, CPCO ) Training Code Books Exam AAPC - Distance Learning For more information or to enroll visit:

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