HIAlearn - Module Catalog

Designed to refine the skills of the experienced coder by providing targeted and interactive sessions in an easily digestible format. Each session last one hour on average and is accompanied by a ten question quiz to ensure comprehension. Topics are derived from common audit findings and range from the day’s most challenging procedures to wider reaching concepts such as principle diagnosis selection.

Take a moment to review the listing below and utilize the search feature if you are looking for a specific topic. If you don’t find what you are looking for, check back regularly as we are consistently adding sessions. We are also open to suggestions for topics you would like to see. Chances are it is already in the works!

Medical-Coder-Education-Health-Education

IPPS Changes For FY 2019

Other Education

Discuss the changes in IPPS for FY2018 that went into effect on October 1, 2018.

Medical-Coder-Education-Health-Education

New ICD 10 CM Diagnosis Codes And Changes FY 2019

Other Education

Review new, deleted, revised ICD-10-CM diagnosis codes that went into effect on October 1, 2018. Review significant changes from clinical perspective in some areas.

Medical-Coder-Education-Health-Education

New ICD 10 PCS Procedure Codes And Changes FY 2019

Other Education

Review new, deleted, revised ICD-10-PCS procedure codes that went into effect on October 1, 2018.

Sample Action Plans

Respiratory Failure Diagnosis Coding

Bronchoscopy & Associated Procedures Coding

Medical-Coder-Education-Health-Education

Advanced Practice Providers

Education

In this action plan, coders learn the documentation requirements to bill for advanced practice providers such as NP, PA, CNM, CSW, CP and CNS.

Medical-Coder-Education-Health-Education

Anesthesia

Education

In the action plan, the coder learns what anesthesia services are, and how to code and bill for them.

Medical-Coder-Education-Health-Education

Arthrocentesis, Aspiration and Joint Injections

Education

In this action plan, the coder learns how to code and bill for arthrocentesis, aspiration of joint and joint injections.

Medical-Coder-Education-Health-Education

Cerumen Removal

Education

In this action plan, the coder learns the nuances of coding and billing for the various types of cerumen removal.

Medical-Coder-Education-Health-Education

Critical Care

Education

In this action plan, the coder learns the definition of critical care, documentation requirements and how to code for these services.

Medical-Coder-Education-Health-Education

Documenting MDM

Education

In this action plan, the coder learns how to correctly assess documentation and assign the Medical Decision Making component of the E and M code.

Medical-Coder-Education-Health-Education

Emergency Dept E&M

Education

In this action plan, the coder will learn how to assign an emergency department professional fee E and M code. The pitfalls in coding these are reviewed.

Medical-Coder-Education-Health-Education

Evaluation & Management

Education

This action plan provides a brief overview of the components of a professional fee evaluation and management code.

Medical-Coder-Education-Health-Education

Global OB Package

Education

In this action plan, the coder learns what the Global OB package is, what is included and excluded and how to bill.

Medical-Coder-Education-Health-Education

Global Surgical Package

Education

In this action plan, the coder learns the definition of global surgical package, what is included, excluded, and what to do when the physician furnishes less than the full global package.

Medical-Coder-Education-Health-Education

Incident-To Services

Education

In this action plan, incident to services are defined and explained. Place of service settings and coverage issues are also discussed.

Medical-Coder-Education-Health-Education

Inpatient & OBS Discharge Management

Education

In this action plan, inpatient and observation discharge management is defined and the proper code assignment presented.

Medical-Coder-Education-Health-Education

Inpatient E&M Services

Education

In this action plan, inpatient evaluation and management coding is described and defined. Coding pitfalls are presented.

Medical-Coder-Education-Health-Education

Inpatient Neonatal and Pediatric Critical Care

Education

In this action plan, inpatient neonatal and pediatric critical care is defined. Documentation requirements and proper code assignment are presented.

Medical-Coder-Education-Health-Education

Laceration Repair

Education

In this action plan, the coder learns how to assign codes for laceration repairs for professional fee billing.

Medical-Coder-Education-Health-Education

Locum Tenens

Education

In this action plan, "Locum" Tenens" is defined and discussed. Documentation requirements are also presented.

Medical-Coder-Education-Health-Education

Medical Nutrition Therapy

Education

In this action plan, medical nutritional therapy is defined and discussed. Documentation requirements and proper CPT code assignment is presented.

Medical-Coder-Education-Health-Education

New and Established Patients

Education

In this action plan, the coder will learn the difference between new and established patients. Definitions are presented and explored.

Medical-Coder-Education-Health-Education

Occupational Therapy

Education

In this action plan, the coder learns what occupational therapy is and how it is coded. Documentation requirements and performance deficits are presented.

Medical-Coder-Education-Health-Education

Osteopathic Manipulative Treatment

Education

In this action plan, osteopathic manipulation is defined and described. Proper documentation and code reporting is presented.

Medical-Coder-Education-Health-Education

Pharm-D Incident-To

Education

In this action plan, Pham.D Incident to services are defined and discussed. Documentation requirements are presented.

Medical-Coder-Education-Health-Education

Physical Therapy

Education

In this action plan, physical therapy documentation requirements and coding guidelines are presented and discussed. Modifier use and therapy cap are also presented.

Medical-Coder-Education-Health-Education

Place of Service Codes

Education

In this action plan, place of service codes are defined and their use on professional claims are presented.

Medical-Coder-Education-Health-Education

Primary Care Exception Billing

Education

In this action plan, the primary care exception is defined, and requirements explained.

Medical-Coder-Education-Health-Education

Psychotherapy

Education

In this action plan, psychotherapy codes are defined and requirements discussed.

Medical-Coder-Education-Health-Education

Scribes

Education

In this action plan, the use of scribes is discussed. Requirements needed to meet coding and billing rules are presented.

Medical-Coder-Education-Health-Education

Shared Visit Services

Education

In this action plan, shared services definitions and the billing requirements are presented. Documentation requirements and coding pitfalls are also reviewed.

Medical-Coder-Education-Health-Education

Surgical Modifiers

Education

In this action plan, the use of surgical modifiers is presented. Definitions and requirements for use are also discussed.

Medical-Coder-Education-Health-Education

Teaching Physicians for E&M

Education

In this action plan will learn about the teaching physician guidelines. Definitions and requirements for coding are presented.

Medical-Coder-Education-Health-Education

Telehealth and Telemedicine

Education

In this action plan, the coder will learn the nuances of telehealth and telemedicine coding and billing. Definitions and documentation requirements are discussed.

Medical-Coder-Education-Health-Education

Time-Based EM

Education

In this action plan, time based evaluation and management coding is presented. Documentation requirements and important caveats are discussed.

Medical-Coder-Education-Health-Education

Transitional Care Management

Education

In this action plan, transitional care management is defined and documentation requirements presented.

No Search Results Found.

    Sample Action Plans

    Respiratory Failure Diagnosis Coding

    Bronchoscopy & Associated Procedures Coding

    Medical-Coder-Education-Pathology

    AIDS and HIV Coding and Sequencing

    Certain Infectious and Parastic Diseases

    The Official Coding Guidelines for Coding and Reporting and Coding Clinic advice will be reviewed as it relates to AIDS and HIV positive coding. The disease is explained along with treatments. Case scenarios are presented to aid the coder's understanding of code assignments and sequencing.

    Anemia Overview- Types-Causes-Diagnosis and Treatment

    Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism

    This action plan provides a working knowledge of the pathophysiology, diagnosis and treatment of anemia to help the coder understand the condition and what to look for in the record in order to accurately assign the code and increase productivity.

    Arteriovenous Fistulas, Grafts and Graft Revision Coding in ICD-10-PCS

    Upper and Lower Arteries and Veins

    In this action plan, the coder willl learn the difference between an AV fistula and AV graft creation and proper root operations. Common diagnoses and procedures to correct these problems will be discussed in detail.

    Biopsy Coding in ICD-10-PCS

    Procedure Coding in General

    In this action plan, we will explore the difficulties in coding biopsy procedures in ICD-10-PCS. Coders struggle with when to assign value “X” for “diagnostic” when tissue is biopsied. The difference between a diagnostic biopsy as an objective and routine biopsy of planned removed tissue will be explained in detail. Correct root operations for various biopsy procedures are discussed. Official coding guidelines will be reviewed. Case scenarios will be included in the quiz to test the student’s knowledge.

    Bronchoscopy and Associated Procedure Coding in ICD-10-PCS and CPT

    Respiratory System PCS

    In this action plan, clinical and technical information related to bronchoscopic procedures will be viewed and discussed. The coder will learn how to maneuver troublesome coding areas in both the ICD-10-PCS and CPT coding systems. Bronchoscopy, transbronchial needle aspiration biopsies (TNBA), forceps biopsies and the difference between lung, bronchial tissue and lymph node tissue biopsy will be explored. All related coding guidance will be explained.

    Cardiac Arrest Coding and Sequencing

    Circulatory System

    This action plan reviews the clinical aspects of cardiac arrest, causes and treatments. Official coding and sequencing advice is also presented to assist the coder in code assignment and sequencing.

    Cardiac Catheterization Procedure Coding in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, clinical and technical information related to cardiac catheterization procedures will be discussed and reviewed. The coder will learn how to maneuver troublesome coding areas in ICD-10-PCS. The action plan will present how a cardiac catheterization is performed, what associated procedures are performed with the cardiac catheterization and how to accurately identify and code these procedures. All related coding guidance will be explained.

    Cardiac Catheterization Procedure Coding in CPT

    Heart and Great Vessels

    In this action plan, clinical and technical information related to cardiac catheterization procedures will be discussed and reviewed. The coder will learn how to maneuver troublesome coding areas in CPT. The action plan will present how a cardiac catheterization is performed, what associated diagnostic procedures are performed with the cardiac catheterization and how to accurately identify and code these procedures. All related coding guidance will be explained including the hierarchy format of the codes and the differences between normal and congenital cardiac catheterization codes.

    Cerebral Edema Overview: Types, Causes, Diagnosis, Treatment and Coding

    Nervous System

    This action plan provides a working knowledge of the causes and types of cerebral edema, pathophysiology, symptoms, diagnosis and treatments available. This will assist the coder in what to review in the medical record to accurately assign a code this diagnosis and increase productivity.

    Cerebrovascular Accident, Infarction, Thrombosis, Embolus or Stroke and Sequelae Coding

    Circulatory System

    This action plan will describe the clinical manifestations of an acute cerebral infarction/CVA/thrombosis/ embolus/stroke and common treatment modalities. Sequelae of cerebral infarction, etc. will also be discussed with an emphasis on when to assign the sequelae codes and when not to. Sequencing, especially involving principal diagnosis will be presented.

    Chronic Kidney Disease Coding

    Genitourinary System

    This action plan assists coders in assigning diagnosis codes for CKD and renal failure. Clinical information, symptomology and treatment are all included.

    Coding Clinic Review to Improve Overall Code Accuracy

    Secondary Diagnosis

    This action plan involves a Coding Clinic look up challenge to improve code assignment comprehension. It helps the coder realize the importance of utilizing official guidance for code assignment.

    Colonoscopy Coding for Outpatients

    Gastrointestinal System

    This action plan is designed to help improve coding accuracy by enhancing a coder’s knowledge regarding the coding of diagnoses and CPT/HCPCS procedure codes for colonoscopies. The various problems in assigning correct codes for patients undergoing colonoscopies will be discussed along with solutions.

    Colostomies- Creation and Takedown

    Gastrointestinal System

    This action plan is designed to help improve coding accuracy by enhancing a coder’s clinical knowledge about colostomies. Having a working knowledge of how a colostomy is formed and how the takedown procedure is accomplished may eliminate the need for extensive research or physician query.

    Common Medications and the Conditions Treated

    General Productivity

    This action plan is designed to help the coder to improve their knowledge of commonly prescribed medications, which may in turn help to increase coding productivity. Special attention will be placed on cardiac and respiratory medications.

    Complication of Transplanted Organ Coding

    Injury, Poisoning and Certain Other Consequences of External Causes

    This action plan will address the complexities of diagnosis code assignment in patients who are of transplanted organ status. Official coding guidelines for complication coding along with other official advice will be presented and discussed. Clinical consideration, as well as sequencing dilemmas will be discussed. At the conclusion the coder will have a solid understanding of how to handle coding of patients with conditions associated with and not associated with a transplanted organ.

    Congenital Disorder Diagnosis Coding

    Congenital Malformations, Deformations, and Chromosomal Abnormalities

    In this action plan, the difficulty in coding congenital disorders will be explained. Official Coding Guidelines for Coding and Reporting and Coding Clinic advice will be reviewed. Case scenarios are presented to aid the coder’s understanding.

    Congenital Disorders Hypoplastic Left Heart Syndrome Diagnosis in ICD-10-CM

    Congenital Malformations, Deformations, and Chromosomal Abnormalities

    In this action plan, a detailed discussion is provided for the congenital condition of hypoplastic left heart syndrome. An overview of procedures related to this diagnosis will be covered. For more detail of these procedures, additional action plans are available. ICD-10-CM coding of this diagnosis will be discussed.

    Congenital Disorders Hypoplastic Left Heart Syndrome Fontan Procedure in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, a detailed discussion is provided for the third stage palliative procedure done for hypoplastic left heart syndrome. For more detail on this diagnosis, see the action plan Congenital Disorders Hypoplastic Left Heart Syndrome Diagnosis in ICD-10-CM. ICD-10-PCS coding of the Fontan procedure will be covered.

    Congenital Disorders Hypoplastic Left Heart Syndrome Norwood Procedure in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, a detailed discussion is provided for the first stage palliative procedure done for hypoplastic left heart syndrome. For more detail on this diagnosis, see the action plan Congenital Disorders Hypoplastic Left Heart Syndrome Diagnosis in ICD-10-CM. ICD-10-PCS coding of the Norwood procedure will be covered.

    Congenital Disorders Hypoplastic Left Heart Syndrome Bidirectional Glenn Procedure in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, a detailed discussion is provided for the second stage palliative procedure done for hypoplastic left heart syndrome. For more detail on this diagnosis, see the action plan Congenital Disorders Hypoplastic Left Heart Syndrome Diagnosis in ICD-10-CM. ICD-10-PCS coding of the Bi-directional Glenn procedure will be covered.

    Congenital Disorders Pulmonary Artery Stenosis and TOF Corrective Procedures in ICD-10-PCS

    Heart and Great Vessels

    In this action plan pulmonary artery stenosis along with other defects diagnoses composing Tetralogy of Fallot (TOF) will be described clinically. The various procedures performed to correct pulmonary artery stenosis and other TOF defects will be explained in detailed. Proper procedure codes to include device selection and approaches are presented. The current diagnosis code vs a history of diagnosis code will be reviewed.

    Congestive Heart Failure and Other Types of Heart Failure Coding

    Circulatory System

    This action plan assists coders in assigning ICD codes for the different types of heart failure. Clinical information, types of heart failure, symptomology and treatment are reviewed. A quiz follows to test both clinical and coding knowledge.

    Coronary Artery Bypass Graft Coding in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, the difficulties associated with “CABG” coding are discussed. The types of bypass grafts (LIMA, RIMA, aortocoronary, etc.), associated procedures and how to read a CABG op note to determine coding are presented. Official coding guidelines are included.

    Cystoscopy and Related Procedures CPT Coding

    Urinary System

    This action plan describes the cystoscopy procedure along with associated procedures performed at the time of cystoscopy. These include TURB, ureteral stent, and cutaneous urinary diversions for example. Anatomy of the urinary system and the actual procedures themselves will be discussed. Coding issues related to cystoscopy procedures including NCCI edits will be presented.

    Debridement Coding in ICD-10-PCS

    Procedure Coding in General

    In this action plan, the coder will learn the different types of debridement and the documentation required by the physician in order to accurately assign a procedure code. Root operations and body part values are reviewed as they relate to debridement. A query example is included to help the coder formulate queries for debridement. This area is audited extensively by third party payers and CMS. It is crucial that correct coding and accurate documentation be present.

    Dental D Codes Introduction

    Mouth and Throat

    This action plan provides the coder with an introduction to assign “Dental Codes” otherwise known as “D Codes” from the CDT book by the ADA. Discussion of code composition, book section outline and details of several common D codes used in the outpatient surgery area are included. Two case studies are provided.

    Diabetic Complications Coding in Patients with a Pancreas Transplant

    Endocrine, Nutritional, and Metabolic Diseases

    This action plan specifically addresses the challenge of coding diabetic complications in patients who have had a pancreas transplant. The transplant can alter how these codes are reported. Clinical information and official coding guidance will be reviewed.

    Drug Use, Abuse, Dependence and Associated Conditions Coding

    Mental, Behavioral and Neurodevelopmental Disorders

    This action plan specifically addresses the challenges of accurately coding drug use, drug abuse, drug dependence and associated conditions and situations. The action plan will address documentation as well as correct coding and sequencing.

    EGD with Endoscopic Ultrasound (EUS) CPT Coding

    Gastrointestinal System

    This action plan helps the coder to understand the EGD with EUS CPT codes and how they are assigned. The descriptors of the codes are very confusing as to what body parts the EGD involves, and what body parts the EUS involves. In addition, associated procedures such as FNA biopsy or injections add to the confusion. Each code is discussed step by step with videos and photos to help the coder understand the procedure and the anatomy involved.

    EGD with Endoscopic Ultrasound (EUS) ICD-10-PCS Coding

    Gastrointestinal System

    This action plan helps the coder to understand the EGD with EUS ICD-10-PCS code assignment. Body part values for the stomach such as the antrum can be confusing and are presented in detail. The difference between tissue and drainage FNA are discussed. The confusion in assigning qualifier “X” for diagnostic in procedures where the objective is to biopsy is reviewed.

    Emergency Department CPT Procedure Coding

    Procedure Coding in General

    This action plan will focus on commonly reported CPT codes from the surgical section of the CPT manual. Procedures such as incision and drainage, nail procedures, laceration repairs, splinting/casting, burn treatments, closed fracture reduction, and foreign body removal will be reviewed. The use of modifiers will also be covered. Please keep in mind, this is only a portion of CPT codes that may be reported from Emergency Department records.

    Endovascular Aortic Aneurysm Repair Coding in ICD-10-PCS

    Heart and Great Vessels

    This action plan is designed to provide an overview of endovascular aortic aneurysm repair. Having a working knowledge of how the procedure is performed and the devices used may eliminate the need to do extensive research during the actual coding process. The coder will be able to make quicker decisions about the choice of procedure codes, or the need for a query just by understanding the basic procedure. This action plan will focus on an overview of endovascular repair of aortic aneurysms and some of the basic terminology used.

    ERCP and Related Procedures Coding in CPT

    Hepatobiliary System and Pancreas

    This action plan helps the coder to understand the differing ERCP CPT codes and how they are assigned and what they actually include. ERCP procedure coding when multiple objectives are involved will be discussed. Official guidance is also presented. Each code is discussed with videos and photos to help the coder understand the procedure and the anatomy involved.

    Excludes1 Note Interpretation

    General Productivity

    This action plan reviews how to properly follow the Excludes1 convention in ICD-10-CM. The differences between Excludes1 and Excludes2 are presented. Example and practice scenarios are discussed. Interim CMS advice on the Excludes1 note is provided.

    External Cause ICD-10-CM Coding Misadventures and Adverse Incidents

    External Causes of Morbidity

    In this action plan, the coder will learn the basics of external cause coding. Indexing, tabular and the different types of external causes are presented. The "IPAS" is discussed. After completing this action plan the coder can then take the other action plans on specific external cause topics.

    External Cause ICD-10-CM Coding Transport Accidents

    External Causes of Morbidity

    In this Action Plan, coders will learn how to index transport accident external cause codes and verify their choices. A 10 question quiz in which the question are open ended further enables the coder to test their comprehension. The coder inputs their answers via code numbers. The quiz will not count errors, however the correct explanation will be given after each question.

    External Cause ICD-10-CM Coding Introduction

    External Causes of Morbidity

    In this action plan, the coder will learn the basics of external cause coding. Indexing, tabular and the different types of external causes are presented. The "IPAS" is discussed. After completing this action plan the coder can then take the other action plans on specific external cause topics.

    Hemorrhagic Conversion Coding

    Circulatory System

    In this action plan, coders will learn what a hemorrhagic conversion is in relation to CVA and cerebral infarction, and how to appropriately code different scenarios.

    ICD-10-PCS Body Part Key Utilization

    Procedure Coding in General

    In this action plan, the coder will learn how to use the ICD-10-PCS Body Part Key to find obscure body parts that are not listed in the ICD-10-PCS tables. Scenarios are used to show the coder how to utilize the Body Part Key.

    ICD-10-PCS Root Operations Review

    Procedure Coding in General

    This action plan will help the coder to review the root operations and their definitions primarily involving the Medical and Surgical Section of ICD-10-PCS. The reading assignment includes reading from the ICD-10-PCS Reference Manual and ICD 10 PCS Official Guidelines for Coding and Reporting. A 20 question quiz follows to test the coder’s knowledge of definitions.

    Increasing Reading Speed

    General Productivity

    This action plan presents reading assignments to help the coder learn how to read more quickly and productively. Speed reading is included.

    Injections and Infusions CPT Coding Part 1 - Introduction

    Administration

    In this Action Plan, the terminology, definitions and hierarchy of injection and infusion coding are presented and reviewed. The different types of injections and infusions are discussed clinically. Coding examples are used to present how to apply the injections and infusions hierarchy.

    Injections and Infusions CPT Coding Part 2 - Coding Examples

    Administration

    Pre-requisite to this Action Plan is Injections and Infusions CPT Coding Part 1 - Introduction. In this action plan, coding scenarios based on the injections and infusions hierarchy are presented and explained. This will help the coder understand the hierarchy and code assignment in various injections and infusions situations.

    Introduction to CMS and Other Quality Measurement Programs and Relationship to Coding

    Principal Diagnosis

    This action plan will discuss the basics of various Quality Measurement programs such as: Value Based Purchasing (VBP); Inpatient Quality Reporting (Hospital IQR otherwise known as Core Measures); Hospital Acquired Conditions (HACs); Hospital Readmission Reduction Program (HRRP); Hospital Value Based Purchasing (HVBP); Hospital Acquired Conditions Reduction Program (HACRP); Agency for Healthcare Research and Quality (AHRQ) and Patient Safety Indicator Composite Group 30 (PSI 30) and; QualityNet.org. This action plan is meant only to be an introduction to quality measurement programs geared to the coder and will serve as a prerequisite to other more detailed and focused Action Plans on these subjects.

    Knee Procedures CPT Coding Part 1- Anatomy and Common Surgical Terms

    Upper and Lower Joints

    This action plan reviews key anatomy of the knee joint that is crucial to understand in order to assign knee procedure codes in CPT. Common surgical terms are reviewed and descriptions of surgeries provided along with informational photos and videos. This Action Plan is a prerequisite to Knee Procedures CPT Coding Part 2 – Understanding Code Reporting and Associated Edits.

    Knee Procedures CPT Coding Part 2- Understanding Code Reporting and Associated Edits

    Upper and Lower Joints

    This action plan explains the NCCI edits that affect multiple code reporting of knee CPT procedures. It is crucial for a coder to understand the NCCI edits and how they affect CPT coding and reporting. Modifiers are also discussed. Key coding challenges along with official coding guidance related to knee procedure CPT coding are presented.

    Laminotomy and Laminectomy Coding: Understanding CPT codes 63030 vs 63047

    Peripheral Nervous System

    In this action plan, the difference between laminotomy and laminectomy CPT codes 63030 vs 63047 will be discussed. This is a confusing area for coders. Clinical descriptions and videos are used to help the coder understand the objective of each procedure and code to be assigned. Official references on the topic are presented.

    Large Intestine Excision and Resection Coding in ICD-10-PCS

    Gastrointestinal System

    In this action plan, the coder will learn how to properly code various types of colon excisions and resections. The coder will learn the differences between excision vs resection of the colon, the individual body part values, and when to code to right or left hemicolectomy. Official guidelines concerning anastomosis of colon, biopsies and incidental excisions are discussed. The importance of proper approach value is also emphasized.

    Long Term Care Hospital (LTAC) Coding

    Principal Diagnosis

    In this action plan, the coder will learn how to properly choose a principal diagnosis and secondary diagnoses for patients admitted to Long Term Acute Hospitals, better known as LTACs. Sequencing can be difficult to discern when the patient is subacute and is being transferred to an LTAC. Official guidelines will be reviewed and scenarios presented. Procedure coding is touched upon. Upon completion the coder will have gained knowledge in choosing the principal diagnosis in LTAC cases.

    Liver Disorders Coding and Sequencing

    Digestive System

    This Action Plan discusses the coding and sequencing of liver disorders such as Hepatic Encephalopathy, Cirrhosis, Hepatitis and liver failure. Problematic areas are addressed.

    Lysis of Adhesions Coding in ICD-10-PCS

    Procedure Coding in General

    In this action plan, the coder will learn when and how to code for lysis of adhesions when performed with other procedures. Root operation, body part value, and official guidelines are presented and discussed. Practice scenarios are provided for the coder's education.

    Malignant Neoplasm Coding: Current vs. History

    Neoplasms

    In this action plan, the coder will learn when to assign a code for a current malignant neoplasm, and when to assign the history of malignant neoplasm code. Case scenarios are presented to help assist the coder's comprehension.

    Mechanical Ventilation ICD-10-PCS Coding

    Extracorporeal Assistance and Performance

    A review of the rules of determining types of mechanical ventilation (invasive vs non-invasive), counting of duration and other issues that may be involved in coding procedures of patients receiving ventilation services are discussed in this action plan.

    Modified Blalock-Taussing Shunt Procedure

    Heart and Great Vessels

    In this action plan coders will learn why a Blalock-Taussig shunt is done, as well as how the procedure is performed. ICD-10-PCS coding of this procedure will be discussed.

    Modifier 59 and X{EPSU} Assignment in CPT Coding

    Procedure Coding in General

    In this action plan, the NCCI edits will be reviewed. Common terms used will be explained. The coder will gain an understand of the edits and when and when not to assign additional CPT codes with modifier -59 in utilizing scenarios.

    Myocardial Infarction Part 1- Pathophysiology of Myocardial Infarctions

    Circulatory System

    This action plan will examine the pathophysiology of a myocardial infarction and how they are classified according to the 2007 standardized definition.

    Myocardial Infarction Part 2- Diagnosis and Treatment of Myocardial Infarctions

    Circulatory System

    This action plan continues the discussion of myocardial infarctions. Emphasis is placed on the diagnostic tools available to the physician for the diagnosis of myocardial infarctions, as well as various treatment modalities.

    Myocardial Infarction Part 3- Coding of Myocardial Infarctions

    Circulatory System

    This action plan is designed to highlight the changes in coding of myocardial infarction using ICD-10-CM. Review of pertinent guidelines and Coding Clinics will be presented.

    Neoplasm Coding in ICD-10-CM Introduction

    Neoplasms

    In this action plan, the coder will learn what a neoplasm is, the different types of neoplasms and how to correctly index and assign diagnosis codes for the various neoplasms. Official Guidelines for Coding and Reporting regarding proper sequencing of primary and secondary sites will be reviewed.

    Newborn Secondary Diagnosis Coding and Reporting

    Certain Conditions Originating in the Perinatal Period

    This action plan specifically addresses the coding and reporting of newborn and neonatal secondary diagnoses. The coder will learn when to report and when not to report secondary neonatal diagnoses.

    Nuss vs Ravitch Procedure for Pectus Ecavatum Coding in ICD-10-PCS

    Upper and Lower Bones

    In this Action Plan, the Nuss and Ravitch procedures, performed to correct pectus evacatum will be discussed. Procedural information about the objective and thus the root operation of these procedures is presented. Scenarios and videos are used to help the coder comprehend these procedures.​

    Observation to Inpatient Status Diagnosis Coding

    Principal Diagnosis

    This action plan will address the complexities of clinical documentation and diagnosis code assignment in patients who are admitted to observation status and then transferred to inpatient status. The importance of correct physician orders and correct principal diagnosis selection we be addressed. This area is a frequent cause of MS-DRG assignment errors. Official advice in this area will also be reviewed.

    Obstetrics Principal Diagnosis Selection and Coding

    Pregnancy, Childbirth and the Puerperium

    This action plan focuses on how to select the correct principal diagnosis on Obstetric/Pregnancy cases. Official Guidelines for Coding and Reporting and other advice is addressed with commentary and practice cases.

    Obstetrics ICD-10-PCS Procedure Coding

    Obstetrics

    Official coding guidelines, correct coding information and descriptions of procedures involving obstetrical and pregnancy cases will be discussed in depth in this action plan. Coders will know when and how to report which procedure codes for various obstetrical procedures.

    Obstetrics Secondary Diagnosis Coding

    Pregnancy, Childbirth and the Puerperium

    In this action plan, the importance of coding and reporting obstetrics secondary diagnoses will be reviewed. Deciphering proper 7th characters in situations where the patient has antepartum, delivery and postpartum related conditions will be explored via official coding guidelines and references.

    Obstetrics Principal Diagnosis Practice Scenarios (Prereq: Obstetrics Principal Diagnosis Selection and Coding)

    Pregnancy, Childbirth and the Puerperium

    *Prerequisite is “Obstetrics Principal Diagnosis Selection” In this Action Plan practice scenarios are presented to teach the coder how to correctly assign the principal diagnosis involving obstetrical and pregnancy cases. Emphasis is placed on “labor and delivery complicated by” and “pregnancy complicated by” differences.

    Pacemaker Procedure Coding in ICD-10-PCS

    Heart and Great Vessels

    In this action plan, the correct coding of pacemaker generators along with proper ICD-10-PCS coding of lead insertion will be presented. Videos and photos are utilized to teach the coder about the different types of pacemakers and defibrillators. Coding of revisions and upgrades are also presented.

    Pain Management Coding and Sequencing

    Nervous System

    This action plan is a refresher in pain management coding with exercises on coding and sequencing guidelines as they pertain to pain management.

    Pancytopenia and Neutropenia Coding

    Endocrine, Nutritional, and Metabolic Diseases

    This action plan will address the complexities of clinical documentation and diagnosis code assignment in patients who are diagnosed with pancytopenia or neutropenia. Official coding guidelines along with other official advice such as Coding Clinic will be presented and discussed. Clinical consideration, as well as sequencing dilemmas will be presented. At the conclusion the coder will have a solid understanding of how to handle coding of patients diagnosed with pancytopenia and/or neutropenia.

    Patient Safety Indicator 15 (PSI 15) Unrecognized Abdominopelvic Accidental Puncture or Laceration Rate

    General Productivity

    This action plan will discuss AHRQ’s PSI 15, Unrecognized Abdominopelvic Accidental Puncture or Laceration Rate. The actual indicator itself will be explored and it’s relation to the coding and reporting of accidental lacerations occurring during abdominopelvic surgery. The controversial issues along with official coding guidance will be explored utilizing coding scenarios.

    Percutaneous Vascular Stent and Angioplasty- Non Lower Extremity and Non Intracranial CPT Coding

    Upper and Lower Arteries and Veins

    This action plan provides a review of angioplasty and stenting procedures. Interventional radiology procedure guidelines and various coding dilemmas are presented as they pertain to CPT coding. Provides the coder with a working knowledge of when and when not to assign a CPT code for an angioplasty.

    Pneumonia Coding - Types, Causes, Diagnosis and Treatment

    Respiratory System

    A review of pneumonia types, clinical indicators, causes and treatments are presented to the coder. Pneumonia code assignment and sequencing guidelines are reviewed.

    Postoperative Complication Coding

    Principal Diagnosis

    This action plan will explore the dilemma of coding and reporting postoperative complication codes based on physician documentation. The difference between expected postoperative conditions and true intraoperative or postoperative complications will be presented. Coding scenarios are provided for understanding.

    Present on Admission Reporting Guidelines

    General Productivity

    The objective of this action plan is to ensure appropriate POA indicators are assigned. This will assist the coder in deciding if a diagnosis or condition is present on admission.

    Principal Diagnosis Assignment

    Principal Diagnosis

    The selection of principal diagnosis guidelines are presented in this action plan. Documentation scenarios are presented to teach the coder how to select the correct principal diagnosis.

    Principal Diagnosis Selection: Acute versus Chronic Underlying Conditions

    Principal Diagnosis

    This action plan specifically addresses selection of the principal diagnosis when the patient is admitted with an acute condition due to a documented underlying cause.

    Principal Diagnosis Selection: When Two Diagnoses Qualify

    Principal Diagnosis

    This action plan is composed of exercises to help select the appropriate PDX when two conditions may equally apply.

    Principal Diagnosis Selection: Symptom Code vs Diagnosis Code as Principal Diagnosis

    Principal Diagnosis

    This action plan specifically addresses selection of principal diagnosis when the patient is admitted with a symptom and another diagnosis. Coding rules related to the sequencing of these cases is presented.

    Principal or Primary ICD-10-PCS Procedure Code Selection

    Procedure Coding in General

    In this action plan, UHDDS, Official Guidelines for Coding and Reporting, and Coding Clinic references are discussed in regards to selecting the principal or primary ICD-10-PCS procedure. Coders will learn how to accurately select a principal or primary procedure, and what to do when multiple procedures are present and no definitive procedure has been performed for the principal diagnosis.

    Reading and Understanding Operative Reports

    Procedure Coding in General

    This action plan is designed to help coders improve their ability to comprehend and accurately code from an operative report, which may in turn help to increase coding productivity.

    Rehabilitation Coding for the Hospital UB-04 and the IRF-PAI

    Principal Diagnosis

    This action plan will review the official guidance on how to select a principal diagnosis for hospital UB04 coding. Difficulties associated with selecting a principal diagnosis since an equivalent code to V57.- is not available in ICD-10-CM will be discussed. MS-DRG impact from this decision is presented. The differences between hospital UB-04 rehabilitation coding and Rehabilitation Unit IRF-PAI diagnosis coding will be reviewed.

    Respiratory Failure-Causes-Clinical Information-Treatment- and Coding Conventions

    Respiratory System

    This action plan reviews the clinical aspects of respiratory failure, respiratory insufficiency, causes and treatments. Official coding and sequencing advice is also presented. Coding pitfalls are discussed.

    Secondary Diagnosis Reporting

    Secondary Diagnosis

    A basic review of official coding guidelines for secondary diagnosis coding and reporting is presented in this action plan.

    Certain-Infectious-and-Parastic-Diseases

    Sepsis Coding and Sequencing Guidelines

    Certain Infectious and Parastic Diseases

    This action plan provides a working knowledge of the pathophysiology, diagnosis and treatment of bacteremia, septicemia, SIRS, sepsis, severe sepsis and septic shock to help the coder understand these conditions and what to look for in the record in order to accurately assign a code.

    Shoulder Procedures Coding in CPT Part 1- Understanding Anatomy and Terminology

    Upper and Lower Joints

    This action plan reviews key anatomy of the shoulder joint that is crucial to understand in order to assign shoulder procedure codes in CPT. Common surgical terms are reviewed and descriptions of surgeries provided along with informational photos and videos. This Action Plan is a prerequisite to Shoulder Procedures CPT Coding Part 2 – Understanding Code Reporting and Associated Edits.

    Shoulder Procedures Coding in CPT Part 2- Understanding Code Reporting and Associated Edits

    Upper and Lower Joints

    This action plan explains the NCCI edits that affect multiple code reporting of shoulder CPT procedures. It is crucial for a coder to understand the NCCI edits and how they affect CPT coding and reporting. Modifiers are also discussed. Key coding challenges along with official coding guidance related to shoulder procedure CPT coding are presented.

    Sinus Surgery (Endoscopic) Coding in CPT

    Respiratory System PCS

    This action plan helps the coder to understand endoscopic sinus surgery procedures in CPT. Nasal and sinus anatomy, terminology and videos are presented to assist the coder in understanding the areas involved in the procedures. In addition, common coding pitfalls are described. Official guidance with NCCI guidelines are also presented.

    Skin and Muscle Graft Coding in CPT Part 1- Understanding Anatomy and Terminology

    Skin and Breast

    In this action plan, the anatomy and definitions frequently seen in skin and muscle graft operative reports are presented. It is crucial that the coder have an understanding of the anatomy of the tissues and the types of grafts performed, and their purpose. After completing this Action Plan, the coder can progress to Part 2 which addresses the actual coding.

    Skin and Muscle Graft Coding in CPT Part 2- Understanding Code Reporting and Associated Edits

    Skin and Breast

    This action plan explains the NCCI edits that affect multiple code reporting of skin and muscle graft CPT procedures. It is crucial for a coder to understand the NCCI edits and how they affect CPT coding and reporting. Key coding challenges along with official coding guidance related to the CPT coding of skin and muscle grafts are presented.

    Skin Graft Coding in ICD-10-PCS

    Skin and Breast

    This action plan reviews the various types of skin grafts from a clinical and surgical perspective. Proper root operations, body systems, and qualifiers for the various types of grafts will be discussed and presented. Videos are used to enhance the coder’s understanding of these procedures.

    Spinal Fusion Part 1- Overview of Spinal Fusion

    Upper and Lower Joints

    This action plan will look at the spinal fusion procedure, with special attention placed on recognizing the components of approach and instrumentation.

    Spinal Fusion Part 2- Dissecting an Operative Report

    Upper and Lower Joints

    In this action plan coders will learn to read a spinal fusion operative report and recognize the information needed to obtain accurate codes. ICD-9-CM, CPT and ICD-10-PCS codes are assigned. It is recommended that the coder complete Part 1 of the Spinal Fusion action plan prior to attempting Part 2.

    Spinal Fusion Part 3- Coding Clinic Review

    Upper and Lower Joints

    In this action plan coders will review relevant Coding Clinics related to spinal fusions. It is recommended that the coder complete Part 1 and 2 of the Spinal Fusion action plan prior to attempting Part 3.

    Spinal Fusion Part 4- CPT Assistant Review

    Upper and Lower Joints

    In this action plan coders will review relevant CPT Assistant articles related to spinal fusion. It is recommended that the coder complete Part 1 and 2 of the Spinal Fusion action plan prior to attempting Part 4.

    Streamline Your Query Process

    General Productivity

    This action plan will help the coder learn how to more quickly gather clinical indicators and write queries more productively.

    Swing Bed Coding in ICD-10-CM

    Principal Diagnosis

    In this action plan, the coder will learn how to choose a principal diagnosis on Swing Bed accounts. This can be an area of confusion for coders, depending on the reason for transfer to the Swing Bed. Coding guidelines are presented along with case scenarios. Secondary diagnosis reporting is also discussed.

    Traumatic Fracture Coding Part 1- Diagnosis Coding

    Injury, Poisoning and Certain Other Consequences of External Causes

    A review of the resources that relate to the diagnosis coding of fractures and bone injuries is presented within this action plan. In Part 2, Traumatic Fracture ICD-10-PCS procedure coding is discussed.

    Traumatic Fracture Coding Part 2- Procedure Coding

    Upper and Lower Bones

    A review of the resources and procedural information that addresses fracture repair procedures is discussed in this action plan.

    Urinalysis: Understanding the Test

    General Productivity

    This action plan is designed to help you increase your coding productivity by enhancing your clinical knowledge about diagnostic testing. Having a working knowledge of what common laboratory findings reveal may eliminate the need to do extensive research during the actual coding process. The coder will be able to make quicker decisions about the choice of principal or secondary diagnoses, or the need for a query just by understanding basic diagnostic tests. This action plan will focus on an overview of urinalysis and what this test may reveal about disease processes.

    Vascular Access Device ICD-10-PCS Coding

    Upper and Lower Arteries and Veins

    This action plan will describe the various types of vascular access devices used in medical care. ICD-10-PCS presents challenges in coding these various vascular access devices given the different components and different ways they are inserted. This action plan explains the differences and how to assign codes for each type.

    Ventricular Shunt for Hydrocephalus Coding in ICD-10-PCS

    Central Nervous System

    In this action plan, the coder will learn what hydrocephalus is and the various shunt procedures performed to correct it. The ventricular shunt will be described along with a video and photos provided. Descriptions of each type of procedure are provided as this can be challenging for the coder. The coder will learn the proper root operations for the differing procedures.

    Vitrectomy Coding in CPT

    Eye and Adnexa

    In this Action Plan, the coder will learn what a vitrectomy is, and the difficulties encountered in selecting a correct CPT code. Photos and videos are used to help the coder understand the procedure. A terminology key is also included along with descriptions of the different types of vitrectomies.

    White Blood Cell Count: Understanding the test

    General Productivity

    This action plan is designed to help you increase your coding productivity by enhancing your clinical knowledge about diagnostic testing. Having a working knowledge of what common laboratory findings reveal may eliminate the need to do extensive research during the actual coding process. The coder will be able to make quicker decisions about the choice of principal or secondary diagnoses, or the need for a query just by understanding basic diagnostic tests. This action plan will focus on an overview of white blood cell count and what this test may reveal about disease processes.

    No Search Results Found.

      Sample Action Plans

      Respiratory Failure Diagnosis Coding

      Bronchoscopy & Associated Procedures Coding

      How can HIA Assist You?

      Let's get in touch

      We would like to learn about your business




      Thank you.

      Let's get in touch

      We would like to learn about your business




      Thank you.

      Let's get in touch

      We would like to learn about your business




      Thank you.

      Request Demo




      Thank you.

      Pin It on Pinterest