What to do if a code can not be found

[Steve Verno]

As it says in the good book:

Give a man a fish, you feed him for today only.
Teach a man to fish, you feed him for life.

[Danni R.]

Nickelaire!!!! I had to think about that for a second. That's a new one, and good one. LOL.

But yes, I agree, if the instructor doesn't help, go higher, for sure.

[Steve Verno]

On thing to know, if you are given the answers, you dont learn. 

By forcing you to think, when you come across something like this when working for a doctor, you will know what to do. 

Lets say you get hired by Dr Scholl, and this scenario happens.  Your doctor depends on you for these answers.   If you cant do the job, your doctor will fire you and then distrust anyone that comes after you. 

I met a doctor last week who refuses to hire anyone that took a class from X school.  His experience with their students is horrific and he informed his fellow physicians.  Sadly no one that graduates can find a job.   

If your online instructor cant help you, are you in the right class?? 

You're paying this instructor to teach you, we arent being paid to be your instructor. 

I  teach online classes and I answer my students the same way by questioning them to guide them in the right direction. 

Wait to see what your instructor says to you.  If you still arent satisfied, then contact the teaching organization that you paid to provide you with this instruction.  If they cant help, go higher to your State Board of Education or the Federal Trade Commission. 

Also, I cant count how many times we get the "I thought you were here to help us out" attitude.  If I had a nickle for every time I get that I can die a nickelaire

[Danni R.]

Good to see you are trying everything you can and must do to find the answer, or at least, where to look; and you are being very honest. Yes, admitting that you don't know the answer and are pretty much clueless is a huge step. If anything you have just grown tremendously as a person and exemplary student... I agree, it is very common for students not wishing to raise their hand to ask questions for fear it means they are dumb. Every instructor can tell you (I used to teach the medical assisting program) that quite contrary, the students that participate actively and ask questions usually turn out to be the best academically, achieve higher grades and get better recommendations (for their leadership).

You said, your instructor has not responded to your post; does this mean you are enrolled in an online self-study course? Why can't you see the instructor in person with your books? Wouldn't that be the better approach than in a post where you really don't know whether the instructor has seen it, or when he/she will respond.

[luckie3b1g]

Okay, so because I do not know the answer to the question, I responded to my instructor telling her that I didn't know and that I would keep looking. She has not responded to my post yet, which I don't think she will until I give her an answer. But because I can't find anything about generic codes, I think that I would just have to request further clarification from the physician if the code could not be found.

Steve I was not trying to be rude or anything, but when I do not know the answer to something, I get very frustrated because in my eyes that means I am failing. I have always been an A student and I take my school work seriously. I did not want to ask my instructor because I didn't want her to know that I didn't know the answer. But I figured I might as well tell her that I didn't know it because obviously I'm not going to figure out the answer if I don't ask.
Thanks for the help.

[Danni R.]

Our forum's Steve has always said, we must code what is charted in the medical record. The diagnosis must match the treatment. I don't know if this helps, but that's all that comes to my mind in reading your question.

[Steve Verno]

Again, my response is the same:

What would you do?


if you dont know, go back and ask your instructor for the answer. 


As a university professor, I may ask a question like this in class to generate thought and class discussion, but at the end of the discussion I provide the answer. 

I may give this question as a homework assignment to see what each students answers would be.  I would have the same question on a pop quiz.  This is how I found some students who cheated.  They had the right answer on their homework with perfect answers as if another coder gave the answer.  They missed the same identical question on the pop quiz by a New York mile. 

Recently a question was asked by a student.  I gave an answer.  The student turned in my answer as her own.  Her teacher and I knew each other, so she called me and said that her students answer sounded like something I would say.  We found the students post and my response.  Long story short, the student was expelled for academic fraud. 

So, discuss, what would you do? 

[luckie3b1g]

One, I would never ask for an answer to a homework question. I posted a discussion for class...
When you look at the CMS-1500 form, you can see that there are many fields, or sections, to complete. Recall what you learned in "What Are Diagnostic Codes?" and "What About Procedure Coding?" in your textbook. In these reading sections, you learned about the two different types of coding. In this forum, compare and contrast diagnostic coding and procedure coding. What information does each provide, and for whom? What circumstances dictate the use of each type of code? Provide a hypothetical, real-life example of a scenario that would require the use of each type of coding. Finally, find an example of an online resource for medical coders, and share it in this forum.
My answer was....

Diagnostic codes are numbers that identify the physician's diagnosis or opinion about what's wrong with the patient. Medical Claims and billing specialist use the International Classification of Disease (ICD) system to find the diagnostic codes. The ICD-9-CM or International Classification of Disease, 9Th Revision, Clinical Modification, list a code for virtually every possible diagnosis a doctor makes. On the CMS-1500 form the diagnostic code is entered in field 21- Diagnosis or Nature of Illness or Injury.

Procedure codes are numbers that describe the services or procedures the doctor provides. Current Procedural Terminology or CPT, or The Healthcare Common Procedure Coding System, also known as HCPCS provide these codes. The codes are entered in Field 24D on the CMS-1500 form.

The ICD-9-CM has three volumes. The first two volumes contain diagnostic codes; volume 3 contains codes for inpatient procedures.

Back in 2008 I was diagnosed with Endometriosis code 617.0, ovarian cysts code 620.2 and an enlarged uterus code 621.2. I had my first Laparotomy code 54.1 in 2008 which was an exploratory 54.11. I had my second surgery (laparotomy) in 2009 to remove cysts and in 2011 I had an Edometrial Ablation code 68.23. If I continue to have problems, I will then have my last surgery, a hysterectomy code 68.4.

http://icd9cm.chrisendres.com/index.php

http://www.icd9data.com/

After my post, my instructor asked me the question about what I do if a code could not be found. I was not expecting anyone to give me the answer. I was looking for help in finding the answer. You could have told me where to look to find it or anything. I have read through my books and I have even looked on the internet and I still can not find it. And me asking questions is how I learn. so going back to what you said, "if you were handed everything, you wouldn't learn. If you don't learn on your own, you don't get ahead." I have never been handed anything and I don't expect to start now. I was using the forum for what it is intended for, asking questions.

[Danni R.]

Respect.

[Steve Verno]

Forums are a guide only, not the definitive answer. Guidance is the best help.  

As a student, your instructor is your answer.  If you have a question regarding what your instructor asked you, you have an obligation to question your instructor for your answers.  

I ask a question to answer a question to get you to think.  If you were handed everything, you wouldnt learn.  If you dont learn on your own, you dont get ahead.  So, go to your instructor with your question.  He/she may have the answer your're looking for. Copping the I thought a forum was here to help attitude is not going to do any good and wont change the answer.

When I was in Algebra class, the book we were given had all the answers in the back. My teacher once told me that he didnt give a crap if I gave him the answer to a question.  He wanted to know how I obtained the answer other than looking in the back of the book.  So, if a+b=c, b=2 and c=10, how did I come up with the answer to what the value of A equals other than reading that the answer is 7.

Last, how do I know that this isnt a homework question you are expected to answer and turn in?  if it is, I dont contribute to educational fraud.  If not then...

1.  When you have a question, ask your instructor.

2.  If you have any doubt, see #1

[luckie3b1g]

wow, that helped me out a lot. Class started a week ago and if the instructor would have went over this, I would know the answer, I would not be asking you all what it was. I am not trying to be rude, but how are you going to answer the question with a question? I thought these forums were put here to help people? hmm Thanks anyway 

[Steve Verno]

THis sounds like one of the many interview questions we are asked to answer about a billion times.

The best way for us to answer:

Using what youve learned so far, as a student, what were you taught to do??

[luckie3b1g]

I have a question, Right now I am getting my degree in Medical Specialties and when I am done, I am thinking about a career in billing and coding. Right now I am taking Billing for Insurance reimbursement. My instructor asked me, "What should you do if you are looking up a code for a diagnosis or condition and there doesn't seem to be a code. Is there a "generic" code that can be used? Or, would you need to request further clarification from the physician?
I do not know the answer to this question. So I thought the best way to found out is to talk with other people in the profession. If you all could help me out with this, I would really appreciate it. Thank you very much!