Monday, December 19, 2016

ASK HIM: I was thrown under the bus by an associate and reassigned to new duties. What do I do now?

Question submitted via email:
I was sabotaged by someone in my office and was reassigned to new duties.  Now the department is in turmoil.  Management simply wants the situation to “go away” and the staff wants me to “fight it.” I just don’t know which way to turn. I like my job, but the situation has made it almost unbearable to do my job. What do I do?

Answer from Marie Janes, MEd, RHIA, FAHIMA: 
I’ll assume it’s safe to agree with you that the situation was sabotage.  It appears you weren’t able to take precautions to avoid the situation, so your options are limited. Your best line of defense is keeping your emotional intelligence in check and continuing to communicate with others. With time, the truth will win out, unless the office politics are extremely toxic, and then you may have to resort to tougher measures. For now, take a deep breath, do your work and concentrate on the big picture. Your credibility will be recognized once the damage is discovered.

Follow-up: Sabotage is the worst of all office conflicts, but employees face daily challenges that affect their feelings and productivity. Some helpful ideas are as follows:
  • Distance yourself from the drama
    • Focus your attention on tasks and responsibilities 
    • Engage in workplace activities that offer a diversity 
    • Be kind, not cruel
  • Document the circumstances 
    • Use your day planner or calendar to document any unusual situations 
    • Guard personal and private reports 
    • Be trusting, but don’t be naive
  • Ascertain whether the coworker was an acquaintance or colleague or unknown
    • Determine your relationship, if possible
      • Saboteurs want you to take them into your confidence and use your own words against you 
      • Maintain your standards and work ethics 
    • Length of time in friendships is not always a gauge of loyalty. 
      • Along with trying to understand the sabotage is the feeling of loss or death of a previous friendship
      •  To compound matters, it’s worse when several coworkers conspire to oust a person
  • Plan for the future 
    • Jot down the pros and cons of remaining at the company or with the organization 
      • Don’t let the saboteur alter your career plans 
      • List reasons to stay 
      • List reasons to leave 
      • Make your own decision (often employment contracts are involved and apply to the situation)
  • Acknowledge your emotions and devise coping mechanisms 
    • Use an employee assistance program (EAP), if available 
    • Seek counseling to alleviate feelings of anger, anxiety, depression, etc. 
    • It’s okay to have a good cry—as long as it is a cathartic episode that clears the air and helps you move forward

Remember the saying, "nothing surprises me anymore."  Just when you’ve think you have life figured out, someone will throw a curveball your way. Be true to yourself and maintain a healthy respect for others. Backstabbers may change an office dynamic, but it may not work out according to their plans.


Do you have a question??  Ask an HIM expert!  We will do our best to answer questions on any topic ranging from HIM, management, beginning your HIM career, CEUs, OHIMA, AHIMA, etc.!  Submit your question HERE.

Wednesday, December 14, 2016

ASK HIM: How do I find a job working from home in the HIM field?

Question submitted via email: How do I find a job working from home in the HIM field?  I am an RHIT with billing and health information experience.

Answer from Lauren Manson, RHIA: More and more HIM positions are being sent home to work these days!  With so many facilities now using Electronic Medical Records, it is not necessary for many positions to remain onsite.

When looking for a work-from-home position, keep in mind the following:

  • Many positions require the employee to be onsite for a period of time and then will later be sent home.
  • Some positions are work from home part-time.
  • Working from home has it perks; but it takes much self-discipline and focus to be successful.  Working from home is not for everyone.  An article titled REMOTE CONTROL: How to be a Successful HIM Telecommuter by Deanna Rasch was just recently published on the OHIMA Blog.  This is a great resource for those who want to work from home!   

Most positions that are work from home will state that they are remote in the job description.  Here are some HIM job categories that possibly are work from home positions:
  • Coding and Billing 
  • Clinical Documentation Improvement (CDI)
  • Deficiency & Correction 
  • EHR Analysts
  • Some operations positions

Check the OHIMA Career Center frequently for new job postings!  It’s free for Job Seekers!  Good luck finding a work from home position! 

Do you have a question??  Ask an HIM expert!  We will do our best to answer questions on any topic ranging from HIM, management, beginning your HIM career, CEUs, OHIMA, AHIMA, etc.!  Submit your question HERE.

Wednesday, December 7, 2016

CPT Code Changes for 2017

This “In the kNOW” topic addresses a major change in CPT coding for 2017 regarding moderate (conscious) sedation.  This type of sedation allows a patient to purposefully respond when given verbal commands after being medicated.  It is not necessary to provide airway or cardiovascular support, and the patient’s own breathing is sufficient.  In the past, moderate sedation was considered part of select CPT codes and identified by the presence of an encircled bullet symbol, like this:

Effective January 1, 2017, there is a new way to code for moderate sedation thus resulting in revisions to many codes.  
A review of Appendix B indicates a large number of codes impacted by this change which is also reflected by review of Appendix G which has been removed from CPT.  Review of the explanatory note found under Appendix G provides coders with the information that the moderate sedation symbol, has been removed from the codes it was previously associated with and that is confirmed in Appendix B, where we see the codes preceded by the moderate sedation symbol with a strikethrough, like this: 

Appendix G now refers coders to new CPT codes 99151-99157 in order to capture moderate sedation, and Appendix B indicates that codes 99143-99150 which applied to procedures where it was appropriate to code moderate sedation separately have been deleted.  These new moderate sedation codes are inclusive of preservice, intraservice, and postservice work.  However, the code selection is solely based on the intraservice time as the pre and post work are included in the codes.  Components of the intraservice time include:
  • Starts with administration of sedation
  • Ends with completion of procedure, determination that patient is stable, and provider face-to-face time concludes
  • Initial and subsequent orders and administration of sedation are included
  • Continuous face-to-face time by provider is required
  • Patient is monitored for sedation response

The new section of moderate sedation codes (99151-99157) are based on 15 minute increments of time as well as the age of the patient, and whether or not the sedation is provided by the same individual who is performing the diagnostic or therapeutic service.  For example, code 99151 is for the first 15 minutes of conscious sedation on a patient who is younger than 5 years old by the same provider performing the diagnostic or therapeutic service.  Add-on codes 99153 and 99157 are for each additional 15 minutes of intraservice time regardless of age.    

Further information on this important change in CPT can be found in the 2017 CPT Manual under Appendices B and G, and in the notes preceding the new CPT codes 99151-99157.  

Now you are In the kNOW!!

If you are interested in learning more about the CPT code updates coming in 2017, register for our webinar on this topic!  

Dianna Foley, the author of this article, will be the presenter on the webinar.  

 See our website for registration and details.

About the Author

Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.