There should be local organizations in your area where you can network with fellow coders. That's the best way to find out the going rate in your area. Certainly, I think it's important to get that certification. I want my graduates to certify both as CCS through AHIMA and CPC through AAPC. In fact, two of them just announced on our private instructional board that they just passed the CCS-P certification exam.

I have seen statistics that show dramatically increased job options for those who are certified coders.

ICD-9 Diagnostic and Procedural Coding

You have to pay for CPT and HCPCS coding through this site, but it's great for diagnostic coding, especially for neoplasms or for ICD-9 procedural coding (which is needed for disability forms, at least here in California). You can access CPT and HCPCS coding if you upgrade Flash. You can enter by description and it will give you all sorts of options. Good for diagnostic coding for poisons or chemical overdose/reactions, too.

[ 11-22-2003: Message edited by: tracielynn ]

When a cast or strapping is applied after the initial treatment, that is listed separately and not included in the global fee for the initial treatment.

Years ago, there was an ophthalmologist in San Diego who advertised the "new laser removal of cataracts" (of course, the phrasing implied that there was some magical way of removing a cataract without an incision). He had scores of elderly people flocking down there...then he would send them home the same day to their own ophthalmologists. Of course, these ophthalmologists didn't have a clue until the patient called for a same-day appointment that they'd had cataract extractions. And the patients thought it was all included in the global fee, and were ticked off that a per-visit charge would ensue. And these patients very frequently had postoperative complications that their local ophtho would have to deal with...and a charge per visit until that problem was hopefully resolved. The San Diego doctor was soon put out of business. But yes, there are provisions for paid services by another doctor, necessary for ER follow-up, but only when the initial physician is different from the physician performing the follow-up. Otherwise, it's double-dipping. It is the surgeon or physician who performs the initial service that determines payment for subsequent services, not the location.

If you know of a physician who is billing just for the removal of a cast, the claims will simply be denied. But it's not really as simple as that...it will flag that doctor for scrutiny if he continues to do it. However, if the removal is followed by a replacement cast or strapping, the appropriate surgical code is used. If, during follow-up, any significant identifiable further service is provided, the appropriate E/M or surgical code is used with a modifier. But a significant service must be clearly charted...because it WILL be audited.

If you are asked consistently to charge for follow-up visits, take the denials to the manager and explain that this is not only a waste of time, but could alert payors to audit the physician. But say it very diplomatically...that's the hard part.

[ 11-28-2003: Message edited by: toobsassie ]