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.
Last week, we looked at tidbits for reporting the ICD-10-CM codes for pregnancy/obstetric records. Now we will look at some for the ICD-10-PCS reporting of these records. In reporting the appropriate ICD-10-PCS codes a coder must know what is included in the terminology of products of conception (POC).
Chances are, we all know someone affected by heart disease and stroke, because about 2,300 Americans die of cardiovascular disease each day, an average of 1 death every 38 seconds. But together we can change that.
There was a time when coding delivery records was considered simple. Many times, these types of records were given to the newer coders. However, as coding becomes more complex, this is no longer the case. With the implementation of ICD-10-CM came more codes for very detailed and specific issues that occur during pregnancy, childbirth and the puerperium.
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our 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 Allison Curry, RHIT, CCS, Coding Specialist at Health Information Associates, about the steps she takes to find her routine.
One way to shorten a lengthy query is by avoiding repetition in the supporting documentation. Does the same diagnosis really need to be mentioned multiple times in the clinical indicators? Is it necessary to list the results of a chest x-ray twice? Does listing the same documentation multiple times give further specification or explanation to the query?
Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases. Tobacco/nicotine dependence is a condition that often requires repeated treatments, but there are helpful treatments and resources for quitting.
This is Part 5 of a five part series on the new 2019 CPT codes. For the remaining areas we will just briefly summarize the section. Due to the intricate nature of these sections in CPT, it is recommended that the coder read the entire section notes associated with the new codes.
This is Part 4 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY 2019 and include examples to help the coder understand the new codes. There is 1 new lymphatic code, 2 new digestive system codes with 3 deletions, 3 new urinary system codes with one deletion and 7 deleted nervous system codes with 2 revisions.
This is Part 3 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There are 9 new cardiovascular CPT codes added with 2 deletions and 3 revisions.
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our 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 Tilina Sablan, RHIT, CCS, Coding Specialist with Health Information Associates, about the steps she takes to find her routine.
This is Part 2 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There are 4 new musculoskeletal CPT codes added with 2 deletions and 0 revisions.
This is Part 1 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There were 15 new integumentary CPT codes added with 3 deletions and 1 revision.
In part 5 of our series, we look at DRG 64—Intracranial hemorrhage or cerebral infarction with MCC. For this DRG recommendation the majority (almost all) were recommended to DRG 65 (Intracranial hemorrhage or cerebral infarction with CC) with deletion of the reported MCC.
The majority of the recommendations from DRG 190 (Chronic obstructive pulmonary disease w/MCC) was to DRG 189 (Pulmonary edema and respiratory failure) with re-sequencing of respiratory failure as the PDX or adding as a new code and sequenced as PDX.
The majority of the recommendations from DRG 853 (Infectious & parasitic disease with O.R. procedure with MCC) were to DRG 871 (Septicemia w/o MV 96+ hours with MCC) with deletion or revision of the PCS code. Some of these required physician query.
The majority of the recommendations from DRG 872 (Septicemia w/o mechanical ventilation 96+ hours w/o MCC) were to DRG 871 (Septicemia w/o mechanical ventilation 96+ hours with MCC) with the addition of an MCC to the account. Not all of these required a physician query and were present in the medical record documentation without any clarification needed prior to coding.
The majority of the recommendations from DRG 871 (Septicemia w/o MV 96+ hours with MCC) were to DRG 872 (Septicemia w/o MV 96+ hours w/o MCC) with the recommendation to delete the reported MCC or query for clarification to support the MCC that had been reported.
Every year, we make plans to live a healthier, more organized, and balanced life. For some of us, we end up falling short of those expectations. This year, to keep us on track with our New Year’s goals, we have put together a few of the most common New Year’s resolutions along with their ICD-10 diagnoses codes. Check out our tips and tricks for a healthy 2019!
Top 5 ProFee diagnosis changes found in recent HIA reviews: 1. I10 – Essential (Primary) Hypertension; 2. E11.9 – Type 2 Diabetes Mellitus Without Complications; 3. K29.60 – Other Gastritis Without Bleeding; 4. R13.19 – Other Dysphagia; 5. I25.10 – Atherosclerotic Heart Disease of Native Coronary Artery Without Angina Pectoris.
What is the principal procedure? The procedure that is performed for definitive treatment or is taking care of a complication is the principal procedure. Procedures for diagnostic or exploratory purposes that are performed in addition to a procedure being performed for definitive treatment, would be reported in addition to the principal procedure.
A query question that is directive in nature, indicating what the provider should document, rather than asking for his/her professional determination of clinical facts, constitutes a leading query. The provider should not be made to feel obligated to document anything.
When I start coding a chart, I enter all account information in log and do any abstracting—disposition, admitting, and attending—take care of all of that first. ED, H&P, consult, progress reports, and discharge summary.
Some Speed Reading Tips: Once you start reading, don’t stop! Read the text straight through. If you have any question after you have completed reading the material, go back and reread the relevant sections. Reread the marked sections of the text (the items you indicated that you didn’t quite understand). Write a small summary at the beginning of the chapter – consisting about 3-4 sentences.
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…