Podcast

Ep 16: How To Get Into Medical Coding with Victoria Moll of Contempo Coding

Listen to the podcast on any of the platforms below, watch the full video interview on YouTube.

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About Victoria Moll

About Victoria Moll, founder of Contempo Coding:

Victoria Moll has built a YouTube channel about medical coding with over 28,000 subscribers! When she was getting her certification, she realized how boring and ineffective some curriculum was, and vowed to improve it.

Since then, she continues to create brilliant content that has helped thousands of men and women enter the medical coding field with confidence.

Follow Victoria Moll through her channels:

YouTube

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Does Medical Coding Have Work-Life Balance?

There’s a lot of people that get lured into medical coding because it has for years, been such a popular work-from-home position. There’s organizations out there that know that and kind of, I don’t want to stay target, but they target people like single mothers that are looking for work-from-home jobs. And they say, “Oh yes this is a work-from-home job and you can work from home and watch your kids.”

But the realistic factor of that is a lot of organizations will let you work from home, they’ll do things like virtual check-ins where they’ll say, “We need you to turn on your camera because we want to make sure that you’re not taking care of your infant while you’re trying to meet productivity standards and accuracy standards. And it’s not because they don’t appreciate the work life balance, it’s that medical coding is productivity-based and accuracy-based.

The Coke and Pepsi of Medical Coding

I think one of the great things you can do with medical coding, if you’re looking to figure out where to start, start at your community colleges, start at your business school to see what theyhave to offer because they can do things like have financial aid.

One of the big considerations with medical coding is most medical coders have to be certified. So there are considerations with being certified. Our two big organizations are AAPC and Ahima. I always refer to them as the Coke and Pepsi of the medical coding world. So while there might be other brands out there, those are the two main competitors. Those are the ones that your employers are going to look for. A certification through AAPC, or Ahima. Because those are time-tested and we trust them.

Transcript

Hey everyone. This is Omar I’m Khateeb head of growth here at Jensen health. And I’m your host here at the journey to private practice. We have a fantastic guest today. Someone who is no doubt, an influencer, and I’m very grateful that she actually spent, you know, carve out a little time to come on our show and I’m super excited to interview her.

The Victoria Moll of Contempo Coding. You might know her also from her wonderful and highly followed YouTube channel, uh, where she talks about all things related to medical coding. So, Victoria, thank you so much for coming on.

Yeah, thank you, Omar. I’m really excited to be here today, specifically to talk to you and just talk to some of your physician audiences as well and stress the importance about medical coding and how it really can impact things for a provider. Absolutely.

And you know, medical coding is such an interesting topic because, you know, as, as it indicates within the name itself, it involves coding, which is highly technical, highly complex.

But it’s one of the few things in the world, in my opinion, coding wise, where it has a direct impact on money and revenue by direct, there’s no way around. And so, you know, I remember when I got into this world just a few months ago, I was like, well, who are the thought leaders here? And when I looked up medical coding, you were everywhere.

And personally, I’m not a medical coder, but I loved your videos. I learned a lot from them. Um, so before we get into that, I kind of want to ask you a question that I don’t know. If you’ve been asked before, but what, what’s your story? What’s your origin story?

So my origin story goes back to actually high school.

So first in order to appreciate. Where I’ve come from and how I’ve grown so much. You have to understand what I was like in high school. So in high school, I was one of the goth kids. I were all black. I had black nails. I, uh, my hair was dyed, like fire engine red. I was very overweight. I didn’t have friends.

I didn’t really like anyone. I think people liked me, but I was just very. Like on my own, like nobody understands me type of person. And I wasn’t a really good student, not because I wasn’t smart. Like I just didn’t get the whole big picture. I, to me, it seemed like I’m going to study a lot to get into a good college where I’m going to study a lot.

And then I’m going to have to get into a job where I’m going to have to work a whole lot. Like, this doesn’t sound like the right thing. Like I, I just kind of trying to figure something out. Like, it just seems like a lot. Work, um, and the reward, maybe wasn’t quite, I wasn’t getting where the reward was. So I just, not that I, again, not that I wasn’t smart, I just didn’t do my homework.

I just kind of didn’t care. I wasn’t okay student. Um, it, uh, I probably would’ve done a lot better if I’d have asserted myself. So I didn’t also know what I wanted to be when I got out of school. I didn’t come from a family where college was really pushed a lot. My mother was a CNA, so she though had known from day one, what she wanted to do.

She loved taking care of patients. She, as a teenager, used to be, I guess what they call the candy striper, where she volunteered at nursing facilities. She loved taking care of elderly patients in particular, our aging population. And that was her lot in life. She loved what she did. She was the type of person that.

You know, she could tell if one of her older patients was going to pass away and there were days where she would come home very late because she would stay with them and hold their hand because she never wanted anyone to have to pass away alone. And my mother was a Saint, she was an absolute Saint and she knew that I had no clue what I wanted to do.

And one day she kind of said to me, she was like, Hey Victoria, you know, there’s this lady that works at the nursing home and she kind of has her own office and she has these. Code books and the doctors leave her charts and stuff. No one really bothers her. She does this medical coding thing. It seems like a pretty good job.

She’s there a day shift hours. She gets there on time. She leaves on time. It doesn’t seem like there’s a lot of work. She just looks up these codes and these books, maybe that’s something you should get it. But of course being the typical teenager, I thought I already knew everything. And I informed my mother that that sounded incredibly stupid and that she probably had no idea what she was talking about.

And I wound up going to community college for web design. So I went to schools for per website for a while. It was a big hobby of mine, still a hobby of mine, more so the design aspect, I think, than the programming and into like the Java script and, and deep spreadsheets and, uh, database type stuff. That didn’t interest me and I was pretty close to graduating, but I still just like, I was just this mass really golf.

Like it wasn’t like anyone, blah, blah, blah, wound up finding out that I was. I was really was just clinically depressed. And I made the tough decision that, you know, maybe I should just kind of take myself out of everything, concentrate on me for a while. Uh, got myself straightened out, you know, but then I finished and was like, okay, well, What the heck am I going to do for a job?

Like I’ve not finished a degree. Um, I’ve got some cool skills, um, in things like working in offices and using software, but I don’t really know what to do with it. So I wound up taking secretarial jobs. I was doing file clerk staff. Eventually I landed in a call center. Kind of, I don’t want to say managing, but kind of a lead at the call center doing online shopping type stuff.

And I just wanted something specialized and I really wanted something more secure. And then I’m like, Hey, you know, mainly of my mom, cause I was at my early twenties at that point, I’m maybe mid twenties and I’m like, you know, maybe my mom was not so stupid after all, like I was starting to get to that age where I’m realizing, oh, maybe you know, that medical coding thing she mentioned wouldn’t be so bad.

So I went back to my community college and they didn’t have a medical billing and coding degree at that time. Like at that time medical billing, coding degrees didn’t really exist. They had medical secretary degrees like medical administration degree. So that’s what I was going to go for. And the lady at the community college looks at me and asks me a question that I have never in my entire life heard someone asked before and she says, do you want a degree?

Where are you looking for a job? And I’m like, what are you talking about? Like since day one of school, everyone has told me, the only way I can get a good job is by getting a degree. And she’s like, well, no, she goes, we have a medical billing program, but it’s over at the technical school. So you get like a diploma, but it’s not an associates degree.

We’ll get you in. We’ll be done at nine months. They’ll train you specifically on medical billing and coding. And that sounds like it’s what you want. And I went, oh, okay. So all I did was just cross over the street to this separate building that the college had. And I started classes in medical billing and coding.

I got a grant from the state, so I actually didn’t pay for anything, which was fantastic. And when I started classes on billing and coding, it was like, wow. This is something I’m actually good at. Like I not only like this, but I’m really good at this. And people are recognizing that I’m good at this. And there’s so many extra skills that I can utilize in this that I already have in this position.

Things like how to format an email, how to do your resume. And I really just liked that. So I finished my community college school and. I took every advantage I could get, you know, I got, I took an externship or internship and, uh, at the local hospital, because this was at the time where provider practices were getting bought up a lot by hospitals and healthcare organizations.

It was like right at the Dawn of that. So the local hospital where I was, was buying a ton. Physician practices and they needed people. They need to build our senior decoder. So right off my internship, I got hired. They said, Hey, we need some people that are certified in coding. If you go out and meet with this instructor and get certified, we’ll reimburse you for the cost of the classes.

So that’s what I did. I went out and got certified. Um, but you know, the materials weren’t great at the time. No fault of my instructor. It was just a lot of. Books. So at that point I had set a long-term goal for myself. Like, Hey, I really want to get into instructing because I think I could make this better.

I could make this more interesting. I could figure out some ways to maybe make this more engaging. So that was a long-term goal of mine. And just wound up going into charge entry. I started teaching evening classes at a technical school to get more experience. I took it then a billing job in AR moved finally into the coding positions, doing coding for.

Hospitalists general surgery, transplant surgery, plastic surgery, which is what I specialize in. I absolutely love plastic surgery. That’s my absolute favorite. Um, and then wound up getting into a lead position, wound up managing a team of coders and auditors started a YouTube channel. I mean, the rest is just kind of gone off from their public speaking events and everything.

So just came from something very small. And like I said, just grew so much out of just that one little opportunity.

That is amazing. I love that because it shows how, you know, sometimes if you just pay attention to the signs that the universe is sending you or your parents, right. Just a little bit action, how much, you know, how much your life can change.

How, how long ago did this, you know, like that this happened for you? Like when, like when you, when you got going and started a YouTube channel, like how many years ago was that?

I’ve only had the YouTube channel for just over a year. You’ve

had your YouTube channel for just over a year. You have thousands of subscribers.

Like I have a YouTube channel myself. It is really hard and like the Wharton. It is. I feel like, you know, having even a thousand subscribers in a niche topic, it might as well be a hundred thousand. That’s really impressive. And by the way, I can see, I’m not surprised that you used to, that you study design because you’re used to.

Videos and the thumbnails are beautiful. I mean, and I, I compare to like other YouTubers, like you, you do a wonderful, wonderful job. What, what, what inspires you to say, Hey, you know, I’m going to start like a YouTube channel. Cause that, that doesn’t seem so obvious.

It’s something that I’ve been toying around with actually for quite a few years.

So prior to getting into medical coding, one of my hobbies I mentioned was web design and I used to be like an internet blogger. And I used to blog about just odd things, pop culture and funny snacks that were coming out cartoons. I used to watch movies that I enjoyed and I wasn’t super popular, but I would sometimes even back then, and we’re talking like 20 years ago, get sponsorships from like Hasbro when they were coming out with the news.

Transformers movie with Megan Fox and them. And they’ve said, Hey, before we’ve released this big movie where re releasing the cartoon version of transformers, and we saw you wrote this funny article about transformers. Would you like to get a screener of the old transformers movie so that you can talk about it on your blog?

So I used to do that, just funny pop culture stuff, and I always wanted to see if there was a way to bring some of those elements into medical coding. I come from a family that’s been very big. Video games. My sister used to run a large video game convention in Philadelphia. She sold it a couple of years ago, and I’ve always been fascinated by the technology used by video gamers and Twitch streamers, and the way that they have.

Taken these audiences and just made just phenomenal amounts of money and fame and stuff with themselves. And I thought, well, there’s got to be some cool elements I can take inspiration from, from these video game streamers and kind of pull it maybe into the tech that we use for business and for medical coding.

Um, I actually recorded a video. A couple of years ago and posted it on YouTube. Cause I, I just, I’ve always been fascinated by video and entertainment and stuff. And now I guess everyone says it’s like infotainment that I do. And. It kind of had to get on the back burner for a while, just because of some family things going on.

My mother unfortunately passed away from pancreatic cancer a few years ago. My father asked me to move back in and just because of spacing and stuff there wasn’t room to record. So it was just over a little year ago, thankfully right before the pandemic that I. House and moved in and set up a home office so that I could specifically record YouTube videos.

And that was something that I actually thank God. I bought that house right before the pandemic, because the housing market right now apparently is not, not so great. It’s quite expensive. And, and, uh, uh, tough, I guess, to find it. A decent house. So the fact that I had a home office already set up right before lockdowns started and everyone was working from home was extraordinarily fortunate.

So the YouTube channel has always been something I’ve thought about. And you know, for the past couple of years there, habit, I I’m certainly not the first person to do this. I won’t be the last person. I’m sure either, but I think. The thought with YouTube in our industry has been, oh, well this is like a webinar dump.

I need to make a video to do a webinar or something. And I’m just going to throw it onto YouTube because that’s free storage. And I think I kind of brought in the element of let’s do some teaching. Let’s do some funny things and that’s what I really wanted to focus on notch. Medical coding, but how can I make this more interesting?

How can I make this more fun? How can I make this more palatable for a relatively dry subject?

No, absolutely. And you know, it’s, it’s still interesting. You mentioned that it makes so much sense now, because I remember again, when I found your videos, not a better recorder, know that I ever had any interest to learn about it.

But when I started this role a few months ago, I was like, I need to learn a little bit about it. And your videos are so compelling. And the fact that you learned. Video gamers and Twitch streamers. And for our audience who are new to this, if you find them YouTube, who’s wildly famous with millions of followers.

It’s highly likely that they started their career as a video game streamer. So like Pewdie pie, biggest, biggest utuber on planet earth. I think w a hundred million. Video gave her all these, like, it’s so funny, how many YouTubers I find where they have like five or 6 million followers from like, how did they do this?

And I go and look at their oldest videos and I’m like, oh, okay. But yeah, they, they did video games. And so you took these elements from another industry and just reinvented and applied it and medical coding and medicine is really, really interesting. I love that. So let me ask you this. So for, you know, there’s a lot of people who are going to be listening to this podcast who might be thinking about medical coding.

Who should be a medical coder and how do they get started? We’re going to definitely leave links to your website and your YouTube videos down below, but just speaking from you from your heart, how do you get started?

So medical coding is something that you really have to enjoy in order to be successful at it. There’s a lot of people that get learned into medical coding, because it is for years, been such a popular work from home position and there’s organizations out there that know that. And they kind of. I don’t want to say target, but they target people like single mothers that are looking for work from home jobs and go, oh yes, this is a work from home job.

And you can work from home and watch your kids. But the realistic factor of that is a lot of organizations while yes, they will let you work from home. They’ll do things like do virtual check-ins where they’ll say, Hey. We need you to turn on your camera because we want to make sure that you’re not taking care of your infant while you’re trying to meet productivity standards and accuracy standards.

And it’s not because they don’t appreciate the work-life balance. It’s that medical coding is productivity based and it’s accuracy based. So even a small error can make a huge financial impact to a provider or to a healthcare organization. So they want to make sure that everyone is on track. So, yeah.

Kids are at school. You’re focused on what you’re doing. You’re really abstracting things correctly. So in order to be successful at medical coding, you have to have those sorts of mentalities in place, knowing that you’re, you have to be accurate knowing that you have to analyze things. There’s so many people out here.

Feel like medical coding is, you know, you look up these things in this book and they think, oh, it’s like a translation thing. Like, you look about a phone number, you just pull up, you know, Mark Jones and there’s a number there and that’s the number for Mark Jones, but there’s so much deeper that goes into medical coding.

There’s things in the federal register. You have to look up, there’s edits. There’s certain codes that you can’t build together. There’s certain codes that you have to have an additional code on or there’s specificity considerations or clinical considerations. Or, you know, evaluation and management is, uh, an art and a science where you have to figure out, you know, how many data elements did you look at?

How many discussions did the provider have and formulate that into a level of service. So, you know, in order to get into medical coding, you have to be someone that understands that this is a lifelong commitment to right. Codes change every year. So you have to keep updated on code changes. You have to know, you know, not clinically to the level of a physician, but maybe to like, um, a medical assistant or someone that, you know, because you want to communicate properly in the healthcare spectrum.

You don’t want to sound like you don’t know what you’re talking about. If a provider says something to you about a certain type. Bone or a certain location of a provider or a disease or a disorder you want to at least be able to articulate what your what’s your, uh, communicating to the provider because you might do things like send queries.

So I think one of the great things you can do with medical coding, if you’re looking to figure out where to start is start at your community colleges, start at your business schools, see what they have to offer, because they can do things like have financial aid. One of the big considerations with medical coding is most medical coders have to be certified.

So there are considerations with being certified. Our two big organizations are a PC and a Hema. I always refer to them as like the Coke and Pepsi of the medical coding world. So while there might be other brands out there, those are the two main competitors. Those are the ones that your employers are going to look for a certification through AEPC or a Hema, because those are time tested and we trust them.

So. You can go directly to AAP for training, they have training programs. They’re just basically going to prepare you more. So for that certification program. So the CPC through the APC is like the biggest one out there. That’s the one that most coders kind of do. Too. So that’s what you want to look for in your programs as well, that they’re going to prepare you for a credential for an exam through AEPC or Hema.

Um, there are other vendors you can go through. There’s all kinds of instructors out there that independently work, that they can train you for those certain exams. But sometimes you also have to consider, you know, med term anatomy and physiology, pharmacology, you know, those might be better. Suited to something more like a business school or a community college where you can take those and there’s facilitated learning.

Now there are self study tools and I actually do have a whole video on my YouTube channel where I talk about, if you think this is something you can self study for that there are certain books that I recommend. Step-by-step medical coding. There’s certain books that you have to buy, obviously for medical coding that you’re ICD 10 cm manual, your CPT, et cetera.

So there is different, uh, Tiers of studying. You can do, depending on how close you are. If you’re someone who’s worked in billing before, you could probably just go right to the AAP C and get a program there. If you’re someone who’s brand new to healthcare, you need med term, you need pharmacology. You probably want to look more at a fuller program through like a community college or business.

Got it.

Yeah. And that, and I think, you know, where to start is so important because I think for, especially for medical costs, You know, people do with what people normally do. You go and search it on the internet. And usually it’s not the quality that you ended up finding someone who spends the money and knows SEO, and you end up spending a 500 or a thousand bucks for, for a core set is outdated and not.

Yeah. So that’s really helpful guys. Now, something that I wanted to ask you about that even me, I didn’t know. And I was educated through your through YouTube videos is that there is a difference between a medical biller and a medical coder. Can you, can you tell us a little bit more about that? And actually I think it’s like, you’re your for fifth, most popular video on YouTube.

Yeah. So there are oftentimes in smaller organizations, the biller and the coder can be the same person, but they really are kind of two different aspects. So the medical coding is looking at the components of the medical record, analyzing them abstracting the key pieces of information, and then translating them into the appropriate code sets, ICD 10 cm CPT, making sure that you’re following suit with things like.

The official guidance in those code sets as well as potentially federal regulations, payer contracts. But the biller is really the one who’s more familiar with the insurance sides of things. So what are the codes that Highmark will accept? So they’ll pay for this code for, at home. But maybe Medicare wants a different code.

So like flu shots, for example, there’s different codes that Medicare wants for a flu shot versus our commercial insurances. So some coders will know some of those components, but the billers are the ones that really focus more on those insurance requirements as well. Fighting some of those bills. So if something gets kicked back by capital blue, cross, that biller will look at it and go, okay, why are they not paying this?

Is it because we built it to the wrong primary insurance? Is it because this patient’s insurance expired? Is it because there was a coding error and maybe now they need to send it back to the coder and go, Hey, can you look at this? Because we want to verify that this is correct. Um, it could even be something like, maybe it was a coding error, but it’s something that.

You know, th the patient maybe didn’t have that. They’re saying, Hey, we don’t pay for this condition for this procedure, but the coder will then look at the documentation and go, this patient didn’t have this condition. Like we can’t code it that way because they genuinely don’t have that condition. Even though it’s the one that gets covered.

It’s just not there. It would be, it would be non-compliance to assign them the diagnosis just for the sake of getting it paid. Um, so there is a coordination that has to happen a lot of times with the billers and coders working together, um, and making sure that both ends are being compliant, but also, you know, we still want to get.

Things paid. So we have to look at things a lot from that payer aspect as well. So the billers are more so working with the insurances, looking at edits, working with those claim forms and following up on those and seeing what ways can we possibly get this claim paid? Yeah, that

makes a lot that it makes a lot of sense, you know, when it comes to medical coding.

So this is an area. Uh, I’ve and it was one surprising areas. That’s something, it’s an area that, uh, uh, physicians take a lot of pride in the sense that like, when I’ve talked to them about medical billing and coding, they’ll say like, oh, we figured it out. Right. We figured out what the quote is. And it’s, it’s kind of like this, like, like bragging rights, like, oh, you know, we figured out this like special combination of coats to use to get this and that, you know, um, what’s, what’s your take on that?

Because it’s something I don’t know a whole lot about it. Part of me, I feel like. I feel like that’s like that shouldn’t be a skill. I feel like it’s a waste of time for physicians to spend on cause they need to be seeing patients everything. And they’re better off dealing with someone who’s an expert.

Right. But I don’t know, maybe I’m wrong, but what’s your take on that?

I think it’s fantastic when coders and physicians can form a great Alliance because as coders, we want them to get reimbursed as much as they do. We want them to get paid for all of the fantastic quality work that they’re doing, but we don’t want them to get paid too much and then wind up having.

Penalties where they might have to pay money back and then get additional fees, paid, have to pay on top of that. And we also don’t want them to under bill. We don’t want them to undervalue a little bit of what they’re doing because they think maybe that they they’re playing it safe. Um, my stance is I would rather physicians be fantastic caregivers and fantastic.

Documenters and document in a specified fashion so that the coder can really abstract what they need to, to the fullest fashion, to get them paid at the highest amount. Um, you know, there are sometimes providers that will talk to other providers and that can be. A little bit dangerous. So if you’re talking to a physician friend, who’s in a different state, they might have different state guidelines in their different scope of practice.

They may be a different Medicare contractor in their word. They have different guidelines than you may have in your state. So there’s considerations there. I’ve had facilities. In the area, even where I am, where I’ve kind of known coders that worked at the facility where physicians thought, oh, you know, I can always put this modifier on it and insurance will pay for it.

And they were adamant, oh yeah, you always put this on. We’ll pay for it. And they thought, okay, this is great. Cause insurance is paying for it and it’ll go out the door and it got paid. But then come to find out, after consultants came in, they shouldn’t be doing it. They continue to continue to continue it until it was found out in discussion.

By the insurance company and they wound up paying hundreds of thousands of dollars back. So while they sometimes think they found these little loopholes, you know, sometimes. They might not be the best loopholes if they’re, they’re not really, truly in compliance. So it’s important to listen to, even though sometimes, you know, maybe we don’t agree with it.

We don’t, we wish it was some way else. We wish we could bill find these little loopholes and bill this extra, maybe, you know, unbundled procedure or something. Oftentimes in the long run, you know, if they’re not compliant, they won’t really be the true benefit. So

scary. And I got to tell you, I mean, this is, you know, my father, uh, was a general surgeon for 30 years, had his own practice, and this is something that affected him.

So for me, like this is a very personal thing. That’s kind of why I joined gen tech, just because Jen time’s really focused on, on this specifically the billing and the revenue cycle part, but that’s okay. On one side in health care, I’ve never heard of an industry or business where you set up business.

It’s like, well, I don’t know when I’m going to get paid or how much, but then on the other side to add to that, it’s like, well, if I get paid a lot, there’s a possibility I’m going to have to pay some of that money back. Right. So that, so there’s, so there’s so much variability and it’s really, really scary.

I want to go back and, and, and, and touch on something you just mention. Very interesting that you said that physicians, the best thing they can do is focus on quality of care, but also on how, you know, just document things and how a document is there like a specific, you know, not, I don’t want to say template, but like Lisa document, what does that, what does that specifically, is it a specific format?

I mean, tell me more about that. Like if a physicians, the physicians who are listening right now, we’re a private practice. What’s your advice to them on, on which on documentation side.

Yeah. So there’s a lot of specificity that needs to go into coding even with our procedures. Was it the right side? Was it the left side?

If you’re doing into something, maybe the skin, how far down into the skin did you go? So really all of those details of what you did and diagnosis coding is coming to the forefront so much now in medicine as well. And reimbursement, there are so many quality payment programs and reimbursements now that are tied to.

Um, programs then part of that is the diagnosis coding. So yeah. Putting out there that the patient has this highly severe diagnosis and that you’re doing really cool stuff with them. You’re keeping them out of the hospital, which is the most expensive hotel in all of the United States. And also, you know, making sure that their lab values are correct, that you’re addressing certain things with them and keeping that cost down.

So with a lot of these severe diagnoses, HIV congestive. Failure cancer we’re anticipating high costs, but if you keep them under a certain threshold, there’s now payment bonuses and all kinds of stuff that contracts usually are happening now that you can get additional money. And part of that is your diagnosis coding.

And the more specific you can get with your diagnosis, coding that can. That shows that there’s more severe diagnoses, right? So there’s more reimbursements attached to a patient. For example, with diabetic nephropathy versus a patient who has no diabetic complications. And sometimes these EMR can get so cumbersome.

And I’ve been in the group with, uh, I was with a hospitalist organization a little while ago where someone brought up, oh, I’m having such a problem, trying to find them. The specified type of diabetes in the EMR is anyone else having problems with this? And I was told to cover my ears while one of the other hospitalists said, just pick the unspecified diabetes code 11.9 and it’ll get it out the door.

Well, it will, but that could potentially cause some problems with reimbursement because now it looks like if you spend a lot of money treating a patient with uncomplicated diabetes versus a patient with diabetic nephropathy that might affect some of those quality tied reimbursement. And so, um, sometimes there’s little tricks that you can do in EMR.

Like you can type in maybe the first three letters of nephropathy and it’ll bring in diabetic nephropathy, but I can certainly sympathize with these providers because I know I’ve seen it firsthand. I’ve worked side by side elbow to elbow with providers and they go into the EMR and they type in diabetes and it gives to them a list of 600 different codes.

And they’re trying to just finish out and close their notes so they can get. Patient and they’re going, I don’t, you know, I’m just going to pick whatever one’s on the top of the list or on my list of selections. Maybe they have a short list or something and just get it out so I can get onto my next patient, because that’s what I want to focus on is taking care of patients, not picking out diagnosis codes.

So, yeah, so that’s what there are, there are things that need the EMR. Sometimes there are prompts that will help that maybe it’ll say, oh, well, is it in model, mild intermittent asthma? Is it with status? Asthmaticus and there might be prompts that will help depending on what your EMR is. If not, that might just be a conversation with your code, or if you’re working with a coder and they see a lot of unspecified codes that might be maybe a monthly conversation to have like, Hey.

These are the unspecified codes that we’re seeing, but it looked like in the documentation, maybe this would have supported something more specified.

So then that makes sense. Just quick side note. So you don’t, don’t worry. Um, your video went out, but it’s still being recorded. The Riverside does that just when, uh, when there’s spotty internet.

So you should be good. Oh, there, I feel like Riverside, you guys listening. Think they’re listening to us. They just put the video back, but no. It’s super fascinating and interesting, especially because of those, those kinds of intricacies. You know, one thing that I wonder is, you know, for medical coder and again, you know, for the medical coders who are listening, they probably, they, they probably know this, but specifically the physicians who are listening.

You know, what are, what are some resources or places that you go to the state? Up-to-date obviously I’m going to put a self as plug-in and say, you know, your YouTube channel, but you yourself, where do you go to stay? Sort of up-to-date with all these changes with CPT and ICD 10 codes.

That is a great question.

So as part of being a certified medical coder, we are required to get continuing education units the same way that a physician is. So we’re required to do so many and complete them in a year. So for one certification you have to get for the APC 36 continuing education units every year. And the more certifications you have that number increases.

Maintaining your seat use is incredibly important. I personally like to get a lot of my information directly from the horse’s mouth. So I go to the CMS website. I go to the federal register. I go to the AMA, but there’s also lots of fantastic resources out there. Like the APC has webinars that they host just about every week or every other week where they bring in experts and you can buy a webinars subscription through them to get information and updates there.

Um, just staying up to date. When you get a new code book and going to the sections where it tells you where the new codes are. Cause every year those codes change. There’s new ones. There’s deleted ones, there’s ones that are revised. And there’s a lot of cool tools that we can use now as coders and even physicians can get access to them, the encoder programs, where you can buy a subscription and it’ll give you information on bundling errors, it’ll give you, you know, um, Survival guides.

It’ll give you CCI edits. It’ll give you information about coding updates. There are. Additions to the ICD 10 and CPT manuals that are paid for. So if we put like every single tidbit about CPT in the CPT book, it wouldn’t be a book. It would be an encyclopedia. So the AMA actually publishes what they call CPT corner, which is additional official guidance that they have.

But you have to pay to get a subscription. Um, ICD 10 also has, when did I see a 10 cm and PCs, both have the coding clinic that you get from the American hospital association. Again, it’s a paid for subscription, but they’re official guidance, official rules that you have to follow in regards to coding guidelines.

So those are crucial pieces that I code or really should have access to. Um, In order to make sure that they’re coding accurately and based off of the official guidance and even just your payers. So knowing, you know, what is published by Highmark or capital blue cross or Aetna, or all the different organizations and staying up to date with them.

Policy changes as well, because sometimes I remember I was working with a bariatric practice a few years ago, and there was a big change with Highmark that they said, Hey, you know how we’ve always said that for years and years, like we want these patients to complete a certain month of, uh, Pre-surgery you training that we want them to go through dieticians and all that.

We don’t need them to do that anymore. So there was a big change that happened in that specialty because of the, the insurance guidelines. So now what are we going to do? Are we going to make Highmark patients not have to go through the pre-surgical program? Like what are we going to do there? So it’s important to stay up to date, not just on the coding side.

But the insurance guidelines as well. Interesting.

Interesting. Yeah, there’s something that, um, I wonder, you know, I, some of the people that I’ve interviewed on this podcast actually specifically Dr. Brent, Lacey, he has a podcast called scope of practice for private practice, actually, selfishly, I’m going to try and introduce you guys.

I think you hit it off and he would probably love to have you as a guest, but something that we talked about is as a business owner, um, you know, Knowing where to invest money so that you can get time back. You know? So even in house, there might be specific tasks that your, your staff is doing that really their time is better spent other places.

But, you know, going back to the differences between a medical coder and biller, like, and I don’t know if this is the right question to ask, but like for a physician, are they better off? Which of those two things should they have in house versus let’s say utilizing an, you know, a company that’s, that’s a third party you’re outsourced, like, is it better to have a medical quote or in-house is better to, or does it, does it really?

Ooh, that’s a tough one. So if we’re talking about, you know, someone who’s in private practice, are they going to potentially outsource a coder or a biller? Um, It’s tough. I’ve seen some billing organizations, you know, a very vast wide differences. Some of them are just so fantastic at what they do and others of them, they go, oh, insurance, didn’t pay for this for, um, you know, we’ll just write it off.

So they’re just very happy to write off charges. So you don’t want to get into one of those situations. Um, You know, the billing side of it really does impact a lot more. I would feel on the exact revenue, you know, fighting those claims and stuff. So I, I would want to keep the billing in-house if you have the choice between the biller or the coder, um, there are tools that you can use.

Do you help a lot with coding? One of the things I hear a lot in medical coding is people go, oh, well, isn’t it going to be gone soon is an AI going to just eliminate medical coding that providers will just get programs that will help them. And I’m like, well, they have that now. And I can tell you, some of the providers are really, really good at it.

A lot of. Not so much. I mean, it’s only as good as you program it. There’s things changing all the time. Um, and you know, nothing against providers, but sometimes they, they mentally think they did something and they may have genuinely done it. They may have billed, you know, done a 9, 9, 2, 1 5 service. They may have clicked the 9 9 2 1 5 because that’s exactly what they did.

And they know in their mind that they did it. But when you look at the documentation that didn’t meet the lot, 9, 9, 2, 1 5, even though physical. They did the 9 9 2 1 5, the paper trail didn’t meet the criteria. So there’s sometimes that disconnect even there that even though they are like, I that’s exactly what I did and I know what I did it didn’t get down on paper and it doesn’t quite warrant it.

Um, So that’s my takeaway. Yeah. And that makes

complete sense. I think that this New York, the model that’s kind of coming up again. Unfortunately, my father, when he was in practices, they didn’t have such a thing is, you know, keeping things, in-house like, you know, the, you know, medical billing and medical coding, but that’s supplementing and investing in your team so that they’re partnered with like, you know, technology or companies that can provide.

You know, better quality data and tools. I mean, that’s kind of our thing with gen 10, which is the billing, the fillers and Colt internal coders love us because it’s a great platform and yeah. You know, they have a team and technology to support them. Um, but I think in medicine in general, I feel like everything, but I’ll speak about medicine that people are way more bullish about like AI taking over and not realizing that it really takes a long time.

Like, you know, people think that robots are gonna take their job and it’s like, we’re really far away from that. Like,

you know? Yeah. What, one of the things I like to consider in that aspect is, you know, Yes, there’s automation. So for example, I have QuickBooks and it looks into my bank account and the assign some of my things.

But at the end of the day, I hire an accountant and I pay that accountant a ton of money to do my books, because if I don’t do them correctly and I just, I can’t go to court and say, oh, well, QuickBooks said that it was fine if I just put all this money here, because I don’t understand all the rules and regulations of everything with accounting.

That’s why I hide it. Specialists who do my accounting for me, because she’s the one that knows what I can and can’t put like, what can I write off for my business? What can I not write off for my business? What are the tax regulations? And I would much rather pay her than risk that penalty that I might not do something correctly with my business and wind up in trouble with.

Yeah.

That’s a great analogy. That’s a great way to put it. Honestly, you know, when a lot of physicians, when I speak to them, You know, sure. Everybody in business, you want to, you, you don’t want to overpay for things, but there is this thing. Like you do get what you pay for. And especially in business, whether it’s billing and coding or marketing or accounting, like you really do get what you pay for.

And I think if it has to do with money, You better off saying, you know, um, I am paying a little bit more, but God, I’m getting the, I’m getting really good quality. And the counting was the same thing. Like for me personally, you know, I have like a little LLC and so I write things off. I do pay my accountant a lot of money didn’t veer, but let me tell you, he does a great job and I always remember turns I get I’m like, thank God I have it.

Can I say doing it myself? Yeah, absolutely. Or going to somewhat cheaper, but how much money am I leaving on the table? I have no idea. Probably a lot. Right. That’s a, that’s a really great, great point. So, Victoria, I do want to be very mindful of your time and I, I have a strong feeling. You’re going to be invited back soon.

I know we’re doing a webinar together. I’m super excited about that, but just in the, you know, last like five, 10 minutes, I kind of want to do this fun thing we do in with some of our guests, which is rapid fire questions. So the, your passion

and you can take as long as you want to answer it in a short, but the faster you answer it, the sooner I go to the next question. Okay. And so, and take, you know, again, there no preparation for it, which is why it makes it fun, but take, take time. You have to think it through that’s totally. Okay. You ready?

Okay. There you go. So question number one. In the last few years, what book blog, or perhaps even podcast had the most impact on your life that you end up recommending it to others?

My friend, Tony L Holmes has this amazing podcast and I would recommend it to every physician out there it’s called the alpha coding podcast and she does a fantastic job just breaking down really common issues that physicians encounter as well as coders.

So that one has really made a true impact on me and Tony and I’ll full disclosure. Her and I have just developed such a wonderful friendship over the past year, just that we. Oddly encountered each other through LinkedIn and developed this amazing friendship and her podcast is just phenomenal.

Fantastic. And I’ll, I’ll leave that in the show notes for it. Wonderful. All right. Next question for you. So, um, in, in everything in our life and especially career, you know, mentorship is super important. Whether you get that mentorship from a parent or a spouse or someone that, uh, you know, you meet professionally, but in your career as a medical coder and, and, and an influencer, what was the most memorable but painful.

Things someone’s ever told you that had a positive impact on who you are today.

So it’s funny, but it wasn’t anyone that I actually worked with in the healthcare industry, but my best friend, Alison and I were having coffee one day and I was talking about work and she says to me, you know what, you’re a workaholic.

And I went, what do you mean? I’m a workaholic. I’m not working until 10 o’clock at night. I’m not doing, you know, a ton of hours. I feel like I balance everything pretty well. And she was like, no, but you are a workaholic. She goes, you’re addicted to your work. She’s like, you always have to be accomplishing something you always have to be after at other certification or hosting another webinar going to another conference or speaking at another conference.

She’s like, you are. A workaholic. And that really resonated with me because I realized that, you know, first off I was spending a lot of time at work and I’m like, well, I don’t want to be a workaholic. Like I want to sit and watch the Mandalorian in the evening, like everybody else does. And I realized that I needed to make some adjustments on what I was doing to better balance.

How much, I love my passion in medical coding and creating education and even doing audits and compliance things and working with physicians and doing teaching. But also, you know, that I have to have a personal life on top of that too. So it’s, that was one of the most important things I think I’ve been told in the past few.

Very, very true and very powerful. I think it’s, it’s, it’s easy for you. A lot of us, a very driven type, a personalities, you know, just to continuously work, make content, everything. But you know, the other side is equally as important because you know, you don’t want to be burning the candle at both ends.

Okay. So couple more, right. Um, this one’s kind of specific to you, but can you tell me, uh, what it means to get struck by Turkey?

Yeah. So there’s a lot of interesting ICD 10 cm codes, basically everything for. Any accident you can think of falling off of a ladder falling off of a diving board, getting struck by a Turkey, getting attacked by a Turkey, getting pecked by a duck, um, struck by an Orca your waterskiis being on fire. So there’s a lot of just ICD 10 accident and injury codes.

That can be very humorous. That’s amazing.

And, and I’m going to leave it in the show notes, but, uh, Victoria has, uh, aside from a great website, she does have a merchandise. And one of the features, these immersion batches struck by a Turkey and the poster. Yeah. The code is in there. So I’m going to leave a link to that.

I thought that was hilarious. I love

that. That’s my, that’s my Thanksgiving special. T-shirt

I’m gonna like put you on the spot here and say like, how come like struck by an orchid? There’s I feel like there’s all kinds of poles out there. I want to see merge for that. Yep.

Okay. So last question for you is, you know, in your, in your off time, right? Uh, there’s, there’s a lot of things that we like to do for hobbies and for fun. What do you like to do for fun? And then what’s the coolest thing, because coming out of COVID, we all bought a bunch of like random thing. I mean, Amazon made a lot of money off of it.

But what do you like to do for fun when you’re off? And what’s one thing that you bought last year that you really did not need, but you’re so happy you bought it.

Okay. Hm. So one thing I can start with what I do in my free time. In my free time. I am a big nerd. I love star wars and Harry Potter and, uh, You know, stranger things.

I am still a huge addict of Pokemon go. So I still play Pokemon go. I go out. One of the things that’s changed with COVID and this is a terrible thing to say, but I used to go out and I always would refer to it as. I basically go out and get in cars with guys that I barely knew. And we would chase around imaginary monsters around town, which is true because that’s what we would do.

We would, there’s certain rates that you have to do and you have to be a certain location. So we would get together. And we kind of knew each other a little bit, but I’d get in their cars and we’d go out to the next raid location and battle Pokemon together. Um, but now with, COVID not getting in cars with random men and going out to battle imaginary monsters.

But on that same note, one of the funny things that I did buy, because I couldn’t get out as much because of COVID and walk around because certain parts there were restrictions. I bought this little machine where I can just set my phone in it and swing it back and forth. Cause. Uh, uh, activities and things you do where you walk and then you get certain Pokemon and hashed out of eggs.

So I bought this little machine that it just swings my phone back and forth while I’m sitting here at work. And then I can get all of these extra, uh, eggs and special things in the post, come on, go game.

And by the way, I did see a meme, uh, during COVID, which was. Do you know, like I miss the time where Pope Pokemon go, you know, like the simpler time where we were just going on and trying to catch Pokemons is like, that was like the last few years. Probably the happiest time I can think of was when Pokemon go came out and people were.

I would like trying to catch Pokemon and stuff and having fun. I was like those ones, very simple, simpler, happier times. Right. So well, that’s fantastic. Well, Victoria, thank you again for chip coming out of the show. Again, I’m going to leave a link in the show notes for everybody. We’re looking forward to doing that webinar with you guys, with you as well, and stay on the, on the line, have a chat with you afterwards, but thank you all again for listening to another episode of journey to private practice.

I’m your host, Omar. With my guests, Victoria, mock Contempo Cody bill, check out her YouTube, uh, channel. Make sure you subscribe and check out the links in the show notes below.

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