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Exempt from MIPS?  Think Again About Participating as a Group

With the first year of the Merit-Based Incentive Payment System (MIPS) already well underway, the Centers for Medicare and Medicaid Services (CMS) began sending out MIPS Participation Status Letters in April. The letters were sent to each Eligible Clinician (EC) associated with a group Taxpayer Identification Number (TIN).  An EC can also check the Medicare Quality Payment Program (QPP) web site to determine his or her eligibility.  The letter and web site contain general information about participation in MIPS, along with email and telephone contact information that should be used if a provider feels his or her status is incorrect.


Radiology Billing and Coding Blog

Know About Cissp Exam

CISSP stands for Certified Information Systems Security Professionals who work for the security of computer system and stop data theft. In fact computer security became a key question in last years of 1980s and requirement for data protection and network security became a primary concern. CISSP professionals work for protection of information from theft, corruption, natural disaster, etc. Additionally, along with protecting the precious data from unauthorized users, CISSP professionals are expected to enable authorized users have access to all the data or system. A concern which was local at the beginning became a global issue and in 1980s computer companies started to put consorted efforts towards standardization of the entire computer protection system.

Came November 1988 when the Special Interest Group for Computer Security (SIG-CS) which was an allied force of the Data Processing Management Association (DPMA) with the help of several other entities from around the world focused on the issue and formed the International Information Systems Security Certification Consortium (ISC). The ISC holds CISSP exams to offer membership to professionals who clear it. Over the time CISSP certification exam has become one of the popular one and candidates from various parts of the world participate to become one of the certified CISSP professional. CISSP certification not only helps candidates get recognition but gives edge to qualifications held by the candidate. Similarly, with due course of time a number of training organizations have come up which claim to train candidates clear CISSP certification exam.
A summary review of CISSP exam shows that the certification program requires a candidate to know about Access Control
, Application Security
, Business Continuity and Disaster Recovery Planning
, Cryptography
, Information Security and Risk Management
, Legal, Regulations, Compliance and Investigations
, Operations Security
, Physical (Environmental) Security, Security Architecture and Design
, Telecommunications and Network Security
, etc. amongst others. Notwithstanding, the issues are so complex that the candidates willing to take CISSP exam may require formal training to clear it. In order to clear CISSP exam a candidate must read and solve previous years’ CISSP exam questions so that familiarity with the genre of question is made possible.
Interestingly, the CISSP certification is valid for only three years. Therefore, after three years, the candidate has to appear for exam and clear it to become a CISSP. However, the re-examination can be avoided if the candidate undergoes 120 Continuing Professional Education (CPE) credits program which is conducted by the organization. With earning and submission of 120 CPEs, an existing member of CISSP can continue his membership even after three years of completion of the membership. The member is asked to pay an annual fee of US$ 85 during each year of the three-year certification cycle before the annual anniversary date.

Ioinfosecurity.com provides certified information systems security professional (CISSP) practice questions and study material. Over the years, the organization has gained credibility in offering study material and question bank for candidates writing CISSP exam.http://www.ioinfosecurity.com/

What You Need to Know About Coding Using EMRs and Encoding Software

I haven’t been perusing as many coding sites and Facebook pages recently as I was a couple of years ago, but I did recently come across a post that captured my attention.  Someone was asking if there was a way to get trained in a popular electronic medical record (EMR) to help them meet the requirements of a job.  It seems many employers are looking for work experience with a certain EMR before considering a person for a position.  Is this fair?  Well, it may not seem fair if you’ve never worked as a coder, but if you have, chances are pretty good you’ve had exposure to some of the major EMR software vendors.  For those of you who don’t have any practical EMR experience, here’s what you need to know.

Is it reasonable to require EMR experience?
First of all, if you’ve never coded before and your coding school didn’t have a relationship with an EMR vendor allowing you to learn the system, any reasonable hiring manager is not going to expect you to have experience.  And if they aren’t reasonable, then you don’t want to work for them anyway (problem solved!).  If I pick up your resume and see you have taken some coding classes and have never worked in the healthcare field but are “proficient” in EMR software, I am going to have more than a few questions for you.  How did you get your EMR experience?  Which systems did you use?  What did you like or not like about it?  In other words, I won’t believe you have experience with it and I will try to weed that out of you.  Or even worse, I may be inundated with resumes and feel like you’re lying about something on the resume and I may not have the time or energy to do any investigating.  Your resume may be relegated to the “no” pile.

Fact: your employer will train you
Here’s a fun fact.  Even if you’ve worked as a coder for 2 years using a certain EMR software, you will have to have training at your new facility.  You may think you know everything there is to know about a certain EMR software, but they are all customizable.  As a consultant, I’ve used the same EMR software at several clients and they are all a little different.  You may find documents stored in different places.  Your favorite EMR feature at Hospital A may not have been “turned on” at Hospital B.  So expect to be trained on the same software you’ve already been using every time you change employers.

EMRs are from Mars, encoders are from Venus
EMRs aren’t the same as encoders.  Of course the EMR is where you will find the medical record documentation, but it is also where you will find financial information and abstracted data.  Encoders and computer assisted coding (CAC) software are usually separate from the EMR.  As a matter of fact, there aren’t a lot of EMR vendors who are also in the business of encoder software.  That makes two different kinds of systems you need to be aware of.  But have no fear: while it’s a plus if you have been trained on an encoder, you can expect your employer to train you there too.

You need to understand interfaces
Rather than obsessing over how to get trained on a particular EMR or encoder, here’s something more important for you to focus on: you need to understand software interfaces.  Because your EMR and encoder are coming from two different vendors and they have to talk to each other, they rely on interfaces.  How that’s set up is not important to you (although it’s very important to the information technology department), but how and why you enter data the way you do is based on interfaces.  I’ve coded for lots of hospitals with lots of different computer systems, but in general, here’s how it works:

  1. You pull up the patient in the EMR.
  2. If you work with a CAC product, you launch the CAC by clicking a button in the EMR.  This opens the CAC using an interface, so that it automatically pulls up the patient you are working on in the EMR and displays medical record documentation for coding.
  3. If you don’t have a CAC, you review the medical record documentation in the EMR and then launch the encoder using a button in the EMR.
  4. Once you are in the CAC/encoder, you code the record.  This software allows you to look up codes and save them to a list.  When you’re done, you click a complete button, and then you find yourself back in the EMR in the abstracting screens.
  5. If the interface is working properly, everything you entered in the CAC/encoder is shown on your abstracting screens.  This is also where you can assign surgeons and dates to procedures as well as any other abstracted data your facility chooses to collect.
  6. You send the account to billing in the EMR by indicating the account is complete.
(Most) EMRs don’t have grouper software
Groupers are the magic software that calculate DRGs and APCs based on assigned codes.  Grouper logic is something that is built into CAC/encoder software, but not into EMR software.  If you ever need to make a change to codes to rebill an account, you can’t just change the code in most EMRs.  It’s pretty standard practice to reopen the account, relaunch the CAC/encoder, make corrections, send them back to the EMR through the interface, and then send for rebill.  This concept is something that many coders don’t understand and, I would argue, this concept is more important than knowing the ins and outs of any particular EMR product as a new hire.
Knowing how to code is more important than anything
After all this, the most important thing you need to know to get a coding job is how to code.  Your employer can teach you everything I’ve mentioned above specific to your facility.  And they can also work with you on enhancing your coding skills.  But it’s more important for you to focus on coding, coding guidelines, and a cursory background in coding reimbursement than it is for you to know an EMR inside-out.  

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LATEST NEWS ABOUT MEDICAL FIELDS

Sweat suits
A sweat suit is commonly associated with sports. But it can be also used in different occasions. A sweat suit is nothing but a simple suit which is made up of a thick material. It is usually made of cotton and polyester. As these suits are worn during physical exercise, the term ‘sweat’ comes along with it. The popularity of these swim suits has started during 70’s and 80’s and still continues intact. And these sweat suits can be used as slim suites. People who are wearing sweat suits are working out in a nylon jumper with the goal being to sweat profusely. While sweating, many toxins will be removed from our body. An example of a sweat suit that can be used to reduce weight is sauna sweat suits. Sauna sweat suits are designed to suit the needs of fitness trainees and for people who are engaged in body building. The results of sauna sweat suit is said to be rapid.
Nurse uniform
A nurse uniform is compulsory for nurse; this is for their hygiene and for their proper identification. The traditional nurse uniform consists of a dress, apron and cap. But nowadays, a lot of variants are there, but the basic style has remained recognizable. The first nurse uniforms were derived from nun’s habit. One of the Florence Nightingale’s students, Miss VanRensealer has designed the original nurse uniform for the first time for the students at Miss Nightingale’s school of nursing. The clothing consists of mainly blue outfit.
Medical scrubs
Medical scrubs are the shirts and trousers or gowns worn by nurses, surgeons and other operating personnel for “scrubbing in” for surgery. Scrubs are designed to be simple with minimal places for dirt to hide, easy to launder and cheap to replace if damaged or stained. The wearing of scrubs has been extended outside of surgical room in many hospitals. Nowadays, any medical uniform consisting of a short-sleeve shirt and pants is known as “Scrubs”. Scrubs may also include a waist-length long sleeved jacket with no lapels and stockinette cuffs known as warm-up jackets. Scrubs worn in surgery are always colored solid light green, light blue or a light-green blue shade; also some medical centers have switched to pink as a theft different. Surgical scrubs are rarely owned by the wearer, due to concerns about home laundering and sterility issues, these scrubs are usually hospital owned or hospital-leased through commercial linen service.
Non-surgical scrubs comes in wider variety of colors, patterns, ranging from official issue garments to custom made whether by commercial uniform companies or by home-sewing using commercially available printed patterns. Some hospitals use scrub color to differentiate between patient care personnel, unlicensed assistive personnel, and non-patient care support staff. Hospital may also extend the practice to differentiate non-staff members/visitors. Scrubs featuring cartoon characters and cheerful prints are common in pediatrician’s office and children’s hospitals, while prints for various holidays can be seen throughout the year. Some scrubs are seen in custom colors too.

Nursing scrubs of all types and colors are available on our website, order complete nursing uniforms for your hospital.

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Find out about medical coding schools

There are many medical coding schools, which offer a variety of online, and offline courses these days. In a matter of two years or so, it is possible to finish one of these courses. Due to the economic crisis, many people are out of jobs, especially good ones.

When it comes to healthcare industry, there is always a demand for healthcare professionals such as doctors and nurses. This is mainly because many people tend to have health problems, more so during these modern times. With the required amount of medical billing and coding training and other necessary qualifications, it is possible for anyone to work in healthcare industry. Doctors who set up individual private clinics require assistance with their administration and billing works.

Since they are too busy tending to their patients and taking care of other key matters, many have taken to outsourcing their medical coding and billing work. The key reason is to cut down on costs. Hiring a permanent staff costs a lot of money compared to outsourcing work. So, if you are currently earning a low salary due to lack of jobs in your expertise, consider attending any of medical coding schools to be a medical coding or billing expert.

Alternatively, you can study from home. Many schools offer long distance learning programs or online courses. Some schools include an interactive program as part of their curriculum for online courses. Therefore, you can ask questions from your lecturer or participate in online discussions. To earn a better annual income, it is best to register yourself as a Registered Health Information Technician or RIT.

For doing so, you need to have attended at least two years of medical billing and coding training prior to application. Passing the exam set by the American Health Information Management Association or AHIMA is also necessary. By being an expert at medical billing or coding, there is a great opportunity to work as a freelancer and earn a great income. It is similar to having your own business. By having a website of your own, you have better chances of attracting prospective customers.

In short, if you are out of a job, consider attending any of the medical coding schools to learn about medical billing or coding. You can work at a private clinic, hospital or any other similar place. Alternatively, you can work as a freelancer at your own time and space. There are many healthcare industries, which outsource their work to cut down on expenditure. Therefore, you have a great opportunity to work as a freelancer and earn good income.

Caitlina is a freelance writer.

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About Medical Tourism

The emergent business of global healthcare, or medical tourism, is generating a lot of income. Seeking medical attention in other countries is seen now as a more practical choice. In the coming year, this $ 20 billion-industry is expected to grow double with more and more people considering getting medical care abroad.

More about the industry

Crossing borders in order to seek medical attention is essentially the practice of medical tourism. The industry has emerged due to the fact that a lot of people are looking for more affordable healthcare. The cost of medical procedures in other countries could be half of that in the US. For people who have no health insurance, this sounds very appealing.

According to reviews, the countries that are now known for catering to medical tourists are Thailand, Singapore, Malaysia, Brazil, and India. Every year, each South East Asian destination gets half a million healthcare visitors on average.

For cosmetic surgery overseas, most medical tourists go for South American destinations like Costa Rica, or Brazil. Brazil tops all other countries with the most number of professionals in the field of cosmetic surgery. There are around 4,500 cosmetic doctors in Brazil today.

Hospitals and clinics abroad are also applying for accreditation from JCI. This institution, Journal of Clinical Investigation, is the same one that sets the standards for hospitals and clinics in the US. An accreditation from this institution ensures patients that they are in good hands, and that the service they are getting is of the highest quality in the world. Currently, JCI has certified around a hundred hospitals outside the US.

Medical tourists can also be assured that medical procedures and cosmetic surgery overseas are performed with the latest technology in the field. Hospitals abroad now anticipate the number of their foreign patient to increase. Medical tourists usually go for popular cosmetic procedures like breast augmentation, liposuction, rhinoplasty, and laser skin resurfacing.

How to plan a medical trip

There are two ways to go about getting an operation done abroad. One can either plan the whole thing on his/her own, or seek assistance from a medical tourism agency. The latter is usually the best choice, especially for people who are unfamiliar with the ins and outs of medical tourism. For a reasonable fee, one is guaranteed that the arrangements for the trip as well as the operation are well taken care of.

When it comes to researching on a particular procedure you are interested in, medical tourism agencies can be a big help. They furnish their customers with information regarding the operation, and they also suggest alternatives and other possible options. Matching a client’s needs with an appropriate destination is one of the main responsibilities taken on by these agencies. They make sure that the country their client is bound for has hospitals that can cater to their customer’s cosmetic needs, and that the trip is well within their client’s budget. More importantly, these companies take on the responsibility of finding a suitable hospital and surgeon for their clients.

Have your cosmetic surgery today to ripped off all the unwanted features you have and turn yourself into a stunning individual. Also, consider travel for better health and see how can you benefit from this. Check out: http://www.cosmeticsurgerytoday.com

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Why You Should Worry About PAMA and Tests

Do you think you don’t have to worry about PAMA because you are a physician clinic? You may be wrong and this assumption could cost you big bucks. Background Section 216 of the “Protecting Access to Medicare Act of 2014” (PAMA) requires the Centers for Medicare and Medicaid Services (CMS) to change how it pays […]
AAPC Blog

Knowing about Medical Coding and Medical Coding Schools

If you are fascinated to get a certificate by attending medical coding programs, then it is very suggestible to pick the correct medical coding schools in order to attain ceiling rewards and jobs following completion of the course. There are various schools accessible for the applicants exactly where they can get admission for instruction. Training sessions can be joined from on-line, as it is handy to most of the college students.

During the coaching classes, the candidates have to go via all locations including anatomy, coding and medical terminology, and so forth. All the instruction components are accessible online and job hopefuls can discover their very own time for these coaching applications. It is suggested to full the instruction sessions of coding training course within a particular time for getting better possibilities.
Different instructors are also available on the internet for serving to the candidates in resolving any doubts related to the system, and candidates can seek out the help at any time. Even paid internships are also obtainable exactly where you can earn and get instruction collectively due to the fact you will be functioning along with the coach or doctor.

Job hopefuls will have various alternatives for getting paid internships from the help like workforce services and vocational rehabilitation.Medical coding work are in higher demand among task seekers these days due to the fact potential for these work is increasing quick. Coders typically function at the back again clinics, offices of hospitals, and other healthcare contributors.

This field can be tough, as the codes alter each and every year. In fact, the healthcare structures upgrade all the codes to analysis various codes. Shifting with the instances is needed for anyone in this occupation. These kinds of amendments really should not flip off anyone since as they say, the only eternal thing in this world is an alter and that relate to medical coding careers as properly.

According to the figures, nearly all medical coders are women; however, males are also joining this field. The requirements for turning into a coder have no gender preferences of any type. Initially, you ought to be excellent with personal computers or at least know operating with OS, simply because this will be your vital tool and the only issue you will be staring at most of the time is your monitor. To grow to be an efficient medical coder, you require to have a high school diploma before applying or enrollment in an accredited coding or billing college.

This profession continues to be an essential crucial in the health care method. With out the coders, it could be challenging for healthcare companies to commune to insurance coverage businesses often. In addition, of course, without codes, injuries and infirmity therapies, documenting methods could be a thorny job to deal with.
Medical coding is a regimen type of career so be certain that you are comfortable operating on a desk before plunging into the coding business. This career may also need a good deal of serenity and fortitude, and you should know what requires for coding or such as in a report.

Problem cracking, investigating and diagnostic abilities are needed to grow to be a successful in this implausible meadow of prospect. You can only attain your aim of studying medical coding, when you get yourself into 1 of the higher profile medical coding schools.

Don’t forget to check out medical coding today!

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5 Things You Didn’t Know About Medical Billers and Coders in Teaching Hospitals

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Medical billers and coders are responsible for translating details in patients’ records to insurance companies for gaining proper reimbursement. Every healthcare organization depends on medical coding and billing staff to remain profitable. Yet teaching hospitals are one of the leading employers of HIT professionals. In general, teaching hospitals are nonprofit medical centers affiliated with a university to train clinicians. They provide round-the-clock care in various specialties, from pediatrics to neurology and cardiac care. Interns and residents treat patients under close supervision from attending physicians. For medical coding and billing graduates, working for a teaching hospital can provide both rewards and challenges. Read on to learn five things you should know about medical billers and coders in teaching hospitals.

1. Medical Coding and Billing Jobs Abound in Teaching Hospitals

The American Hospital Association reports that there are 5,627 registered U.S. hospitals total. Of these, 1,038 are teaching hospitals with high patient numbers. Some of the best are Yale-New Haven Hospital, NYU Langone Medical Center, and Johns Hopkins Hospital. Teaching hospitals employ more than 2.7 million healthcare professionals nationwide. It’s no surprise that medical billers and coders find less competition for jobs in teaching hospitals. After all, university-affiliated hospitals house 82 percent of the country’s ACS-designated Level I trauma centers. Teaching hospitals need large medical records management offices to protect inpatient and outpatient data. Medical coding and billing specialists can expect jobs in teaching hospitals to multiply because the field projects 10-year job growth at 15 percent.

2. Teaching Hospitals Provide Higher Salaries to Medical Coders and Billers

In comparison to several other healthcare settings, teaching hospitals grant above-average salaries to their medical billing and coding staff. According to the AAPC 2015 Salary Survey, medical billers and coders make $ 50,925 on average at inpatient teaching hospitals. That’s more than the $ 44,870 at mid-sized medical groups and $ 45,722 at independent physician offices. Teaching hospitals on the Pacific Coast from Hawaii to Washington report the highest medical coding and billing salaries nationwide at $ 57,021. Landing a job at a teaching hospital can considerably pad your paycheck, especially if overtime is offered. Due to their large size, teaching hospitals are also more likely to hire clinical coding directors with lucrative salaries.

3. Medical Billers and Coders Benefit from Learning Support

Teaching hospitals offer an academic-focused work environment where cutting-edge education and research is prioritized. Medical coding and billing jobs may require less post-graduation employment experience because on-the-job training is included. Teaching hospitals encourage staff to sharpen their skills with continuing education. For instance, Rush University Medical Center provides full-time employees with $ 5,000 in tuition assistance each year. This makes attending college online or during evenings more affordable. Medical coders and billers in teaching hospitals also join an active research community. Teaching hospitals receive approximately $ 2.2 billion in NIH research funding annually. Therefore, the HIM department will continually search for the latest tech advancements to streamline medical coding and billing.

4. Teaching Hospitals Require Extra Vigilance in Medical Coding and Billing

Being careful and attaining high accuracy is important for every medical coder. But those employed in teaching hospitals often have extra responsibility in checking over patient records. Teaching hospitals always experience new rotations of interns and residents who are unfamiliar with record protocols. New waves of med school students can mean patient records accessed by coders and billers are less orderly. One study found 10 percent reduced mortality risk at teaching hospitals, so they don’t compromise quality of care. However, clinical documentation can get muddled in the process. Teaching hospitals may hire experienced coders and billers to conduct medical auditing. Pursuing the AAPC’s Certified Professional Medical Auditor (CPMA) credential would come in handy here.

5. Medical Coders and Billers Frequently Process Larger Claims in Teaching Hospitals

Teaching hospitals typically charge more for medical services because they treat higher acuity patients with complex conditions. Funds are also included for the hospital’s research and academic instruction. For example, George Washington University Hospital charges $ 69,000 on average for lower joint replacement. Sibley Memorial Hospital, a nearby community hospital, charged under $ 30,000 in comparison. Medical coders and billers must be prepared to figure the dollar signs with higher hospital rates. Considerable time will be devoted to coding for diagnostic tests because teaching hospitals order 7.1 percent more tests than their non-academic counterparts. Medical billing specialists should be aware that teaching hospitals are largely urban and accommodate vast numbers of Medicaid or uninsured patients.

Related Links

    The 10 Best Online Medical Coding Programs
    Top 10 Medical Billing and Coding Schools
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Top Medical Coding Schools

Code for the Day: It’s All About Heart (I21.-& I22.-)

I am not a fan of Valentines Day.  And please don’t mistake this for bitterness, I just find it ridiculous that we have a holiday dedicated to telling the ones we love that we love them when there are 364 other perfectly good days in the year to confirm the sentiment.  So I really just see Valentines Day as an excuse for my grocery store to mark up the cost of roses for 2 weeks in February.  And let’s be real here: I hate the combination of pink and red hearts.  I don’t know what it is, but it makes me queasy.  Pink hearts alone are fine.  Red hearts alone are dandy.  But together, ick.  And it get even worse when they throw in those purple hearts for good measure.

As I sit here with my pink heart necklace – after all, I am a festive person and there are no red hearts in sight – I do like Valentines Day as a reminder of something more important: February is American Heart month.  Maybe you “go red” on Fridays or wear a red ribbon.  Maybe you take the month to become more educated on heart disease and the warning signs of a heart attack.  Today, I think we should definitely focus on ICD-10 coding for myocardial infarction!  So consider this my valentine to you: a short tutorial on what to expect in ICD-10 for coding myocardial infarction.

The first thing you need to know is that the definition of an acute myocardial infarction (AMI) has changed.  It is no longer one that has occurred within the past 8 weeks, the period is now reduced to 4.  You also no longer need to know if the AMI episode is the initial or a subsequent encounter for treatment.  In fact, forget everything you know about coding AMI in ICD-9-CM because it will just confuse you in ICD-10-CM.  Here are the highlights:

  • The new period for an AMI is 4 weeks
  • The terms ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) are now part of the code titles, not just inclusion terms for the codes
  • AMI codes to two categories: 
    • I21, ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
    • I22, Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
  • Additional characters report the specific site of the AMI (heart wall or vessel)
  • Sequencing depends on the circumstances of admission

The key to knowing when to use a code from category I21 versus one from category I22 is not when the patient receives treatment, but for which AMI he is receiving treatment for.  

Let’s take an example.  Bob comes in February 14 with a heart attack.  This is so tragic for Bob’s wife, who did not get her roses.  For this Valentines Day visit, we assign a code from category I21 for an initial AMI.  This is the first heart attack Bob has had in the last 4 weeks.  

Let’s say Bob comes back on his anniversary, February 28 with a second heart attack. I’m really starting to feel sorry for Bob’s wife.  Oh, and Bob too. For this second visit, we would assign a code from category I22 to show that this is a subsequent heart attack that occurred within the 4 week period of his initial heart attack.  You would assign a code from category I21 as a secondary diagnosis to report that first heart attack on Valentines Day.

As for sequencing, notice in Bob’s case, I22 was put first on the second visit since it was the reason for his admission (after study, yada yada).  But what if Bob had been admitted for that first heart attack on the 14th and experienced his second while he was an inpatient?  In this case, the I21 would be sequenced first with I22 as a secondary.  Again, sequencing depends on the circumstances of admission.

I’ll just let that sink in a bit.

Have a healthy and happy Valentines Day and enjoy the ones you love.  And if you must indulge, might I recommend some antioxidant chocolates and heart-healthy red wine?  Stay away from those overpriced roses!

Coder Coach