Find Your Routine: Set Your Own Schedule to Maximize Productivity
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our new series, Find Your Routine, we interviewed our most productive coders and asked them what steps they take to find a rhythm that works for them.
This week, we talked with Amy Pang, RHIA, CCS, Coding Specialist with Health Information Associates, about the steps she takes to find her routine.
Q: Describe in detail your daily routine.
A: I like to work later hours. My most productive hours are between 11 a.m. and 11 p.m. The key for me is to get as much quality sleep as I can – getting good rest allows me to think more clearly. I like to get my errands done in the morning so that I can focus all of my attention on work later in the day.
A few years ago, I read this article from the Harvard Business Review about the ideal work schedule. The article explains that “humans have a well-defined internal clock that shapes our energy levels throughout the day: our circadian process, which is often referred to as a circadian rhythm.” It really spoke to how I work best, which is with a flexible work schedule. Part of the reason HIA is such a great fit for me is because they allow me to set my own schedule and work at hours that optimize my daily energy levels. If you allow your employees to work at your most productive time, then you will get the most out of them. I worked in the restaurant business from the time I was 14 until my early 20’s, and that means I’m used to working and being productive at later hours in the day. So, HIA and our client allows me to set my work schedule for later hours to be my most productive self.
Q: How do you maintain your routine day after day, week after week?
A: Quite a bit has to do with how fast I read and skim the records. To be honest, I am surprised I am one of our most productive coders but am very honored to be on this list. HIA hires the best of the best! Which is another reason I have stuck around for almost 15 years. I work with amazing, smart and caring people; they always have my back.
Additionally, I really feel that I have found the perfect fit with the perfect client. I continue to find my work fascinating and interesting. Almost every day, I learn new diagnoses and procedures at my client site. I love that I am constantly learning and at a health system that keeps my interest. My client site is a research facility that uses the newest technology, so I am forced to do a lot of research to support them, which keeps me on my toes. At my site, I am able to use everything that Pat and Beth and Kim send out as far as new updates.
I truly love to learn, and I get that at HIA. When I first started, I made that very clear, and they have lived up to my expectations. One of the best things HIA offered me as an employee was assigning me to work at challenging client sites, where I could continue to learn and grow my knowledge and skills.
Finding the right fit for the coder is key. For me, the hardest clients are the best fit.
Q: What techniques have you found to minimize distractions?
A: Minimizing distractions is hard. I found that, because I am able to start later in the day, I can get a lot of my chores and errands done in the morning before I start work. This helps me minimize the distractions I would have otherwise been thinking about all day long. IF I had to go in at 8 a.m., I would be thinking about the things on my to-do list—groceries, UPS, pick up this or that. Setting my own schedule, works best for me and helps minimize those distractions that I would otherwise stress about all day long.
Q: What are the productivity goals that you set for yourself? And how do you track them?
A: My goal is to do as much as I can. Angie [Christen, VP of Operations at HIA] once said, “ask yourself if you can do one more chart each day.” Angie is very inspirational to me. She is such a go-getter. This challenge to push yourself to do that one more chart a day is something I remind myself of a lot. Using a chart timer or clock helps as well and allows me to constantly monitor myself to keep pace. Sometimes when I do get bogged down in a difficult chart, I stop coding it and come back to it at the end of the day. Sometimes when you come back to it, you are refreshed and not stuck on that same thinking mode.
Q: What motivates you the most? Positive feedback from managers, self-motivation by reaching personal goals, financing incentives? Or other?
A: I am very self-motivated. Over the years, I’ve completed nine marathons without any professional training. I really enjoy that challenge to try to be the best at everything that I do. It makes me feel good to exceed my own expectations. I always think that if I was managing someone, what would I expect out of them? I enjoy meeting, and even exceeding, those expectations that I would have for someone else. Like with running marathons, it releases endorphins to always do your best and validates the effort I am putting in.
TIP: One more tip, I write a lot of coding notes on index cards. I developed the habit of using index cards to study in college and it was very helpful. To this day, I’m obsessed with this learning/memory jogging method.
The picture below is an example of how I use the index cards to help me code faster. I believe these were once new technology codes and I rarely see them. So, the index cards help me to remember to code them when I encounter these procedures.
Also, SharePoint is a BIG help in assisting me to code faster. A lot of the difficult cases I have issues with are answered in SharePoint.
In HIA quality reviews we are finding that some coders are reporting Z41.2—Encounter for routine and ritual circumcision, during the male newborn birth admission, when circumcision is performed prior to discharge.
The cause/etiology of GI bleeding is not always easily determined. During procedures, to work the bleeding up, there are often multiple potential sources of bleeding found but not identified as the culprit. Many of these findings have “with” or “in” in the main or subterms.
On December 1, 2018, the HIA team based at our headquarters in Pawleys Island, South Carolina received a visit from a surprise guest – meet Otis, HIA’s very own Elf on a Shelf. Otis will be sticking around until Christmas to keep an eye on all of us. We have a feeling he may get into some trouble! Check back daily to see what Otis is up to. #OtisOnOtisDrive
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our new series, Find Your Routine, we interviewed our most productive coders and asked them what steps they take to find a rhythm that works for them. This week, we talked with Crystal Junkins, CCS, CPC, Coding Specialist with Health Information Associates, about the steps she takes to find her routine.
COPD is a respiratory condition where there is chronic obstruction to airflow in the lungs. Air is breathed into the lungs but a patient with COPD has trouble emptying air out of the lungs. This can also cause patients with COPD to have CO2 retention. COPD is an irreversible and progressive disease in which the lung function worsens as time goes on.
Tissue findings interpreted by a pathologist are not equivalent to the attending physician’s medical diagnosis based on the patient’s clinical condition. If the attending physician has not indicated the significance of an abnormal finding within a pathology report…
It’s that time of the year where HIM professionals take a peek at what changes are coming for CPT in the new year, 2019. Did you know that CPT started in 1966 with about 3,500 codes? For 2019, there are a total of 10,294 CPT codes.
For FY 2019, ICD-10-CM has added a new code for reporting of lacunar cerebral infarction. This is good news for coders since we see this specific type of cerebral infarction documented often. The new code that is reported for lacunar infarction is I63.81 —Other cerebral infarction due to occlusion or stenosis of small artery.
In 2003, the Centers for Medicare and Medicaid Services (CMS) implemented Risk Adjustment Factors (RAF) and Hierarchical Condition Category (HCC) coding to identify individuals with serious and/or chronic illnesses and assign them a risk factor score that is based on a combination of demographic information and reported diagnoses.
The ICD-10-CM/PCS code changes – effective October 1, 2018 to September 31, 2019 – could be the culprit. Comparatively speaking, there are far less changes this year than in years past. The release includes: 279 new codes, 51 deleted codes,143 revised codes. But don’t let the smaller amount of changes fool you…
With the publication of the new ICD-10-CM Official Guidelines for Coding and Reporting for FY 2019, we finally have an answer regarding reporting of BMI in pregnancy. The new guideline does state “do not assign BMI codes during pregnancy.”
Conflicting documentation occurs when health care providers call the same condition different things. When none of the documented conditions are clearly ruled out by the physician, coders may find it necessary to query for the most appropriate diagnosis.
In reviewing hundreds of contracts, the OIG found that insurers overturned 75% of their own denials upon appeal—approximately 216,000 denials each year. However, while the odds of winning an appeal are seemingly good, many providers simply don’t have the time or the internal staff and infrastructure needed to engage in the process.
When coding a record with documented bullying, this is coded as child or adult psychological abuse (initial/subsequent encounter or sequela) either as confirmed or suspected. The encounter and whether this is confirmed or suspected is needed in order to assign the appropriate diagnosis code.
It’s Halloween season! It’s time to overindulge on candy, fight over the best costume, become irrationally scared of things like the number 13, and have nightmares of your 6th birthday with that terrifying clown. As for us, we’re getting in the spirit with 13 spooky ICD- 10 codes! Beware – it’s scary out there.
Section “X” is a separate place within ICD-10-PCS for certain new technology procedures (such as new technology drugs). Section “X” does not introduce any new coding concepts or unusual guidelines for correct coding and maintains continuity with the other sections in ICD-10-PCS.
Coding Tip: New ICD-10-CM General Coding Guideline — Coding for Healthcare Encounters in Hurricane Aftermath
With the Hurricane season in full swing, this new guideline will be helpful in reporting the external cause codes when an injury occurs as a result of the hurricane, and also help in determining sequencing of the reported codes.
The refined Stroke 30-day mortality measure (MORT-30-STK) is a statistic defined as death occurring within 30 days of a diagnosed stroke. The Centers for Medicare & Medicaid Services (CMS) publicly reports a 30-day hospital-level stroke mortality measure on Hospital Compare as part of the Inpatient Quality Reporting (IQR) program.
“Lobar” pneumonia references a form of pneumonia that affects a specific lobe or lobes of the lung. This is a bacterial pneumonia and is most commonly community acquired. Antibiotics are almost always necessary to clear this type of pneumonia.
We have seen a lot of recommendations of late where the coders are coding hydronephrosis, UTI and ureteral stone separately or not with the correct code to include all conditions.
Coders have struggled for some time with the dilemma of when to assign the combination code of carotid stenosis, with cerebral infarction (i.e.I63.231) and when to assign separate codes for the specific cerebral infarction and carotid stenosis. (i.e. I66.01 and I65.21).
Queries in a Yes/No format are limited to use in the four specific circumstances. This format may not be used when only clinical indicators of a condition are present, but the diagnosis has not been documented in the health record.
Since the implementation of ICD-10-PCS in 2015, yearly changes have been made regarding the definition of, and guidelines associated with, the root operation Control. This has caused coding professionals much confusion in determining whether to assign a procedure to root operation Control, to assign another root operation, or to not assign a procedure code at all.
The policies in the IPPS/LTCH PPS final rule further advance the agency’s priority of creating a patient-centered healthcare system by achieving greater price transparency, interoperability, and significant burden reduction so that hospitals can operate with better…
In this current, ever-changing healthcare climate, health systems face many challenges. Facilities large and small must be dedicated to improving documentation and reducing complications, HACs, infection rates, and readmissions as they endeavor towards value-based care. Coding inaccuracies can really undermine…
It’s imperative, in today’s challenging healthcare environment, that organizations demand complete and accurate coding practices from their vendors if they want: Appropriate and timely reimbursement; Representative quality measures; Improved CMI; Reduction in payor denials and; Mitigation of compliance risks.
In addition to positive clinical indicators documented at the time of admission, any of these that occur within the few days after admission should also be included. This will support the fact that sepsis could have developed after admission. It is important that a POA query give equal attention to what supports POA yes, as well as POA no to avoid the appearance of a leading query.
This major proposed rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute.