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where am I supposed to learn code linking?

T

The Angel Of the South

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So I started the CPC-A practicum, but quickly figured out that I'm not ready to go any further, because the module cases require code linking and I haven't learned anything about code linking yet. Is that in the codebooks somewhere? If not, where else do I look to learn it?
 
Frankly, I'm not sure what's meant by 'code linking', unless it means that your CPT and diagnosis codes must correspond to show medical necessity. Can you give an example of what they're looking for?
 
Pam Brooks said:
Frankly, I'm not sure what's meant by 'code linking', unless it means that your CPT and diagnosis codes must correspond to show medical necessity. Can you give an example of what they're looking for?
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I am severely restricted in giving an example, because the practicode rules explicitly state that I may not share what I see. In calling it "code linking," perhaps I did not use the correct phrase, because it was new to me. Linkage, then? The relevant part of the rationale starts with: "The correct coding with linkage for this case is"; then it seems to link the ICD codes with the CPT codes thusly: [ICD code]/n[CPT code]/[modifier].
 
The Angel Of the South said:
I am severely restricted in giving an example, because the practicode rules explicitly state that I may not share what I see. In calling it "code linking," perhaps I did not use the correct phrase, because it was new to me. Linkage, then? The relevant part of the rationale starts with: "The correct coding with linkage for this case is"; then it seems to link the ICD codes with the CPT codes thusly: [ICD code]/n[CPT code]/[modifier].
Click to expand...


The CMS 1500 claim form (physician billing claim form) has diagnosis codes and CPT codes. There's a field on the claim forms that points each CPT code to a diagnosis.

In Practicode, you can typically just link all of the diagnoses to each CPT code. (Unless there's something very specific in the note that tells you XYZ test was ordered for ABC diagnosis.)
 
I was trying to post a screenshot of a 1500 to show where the fields are, but for some reason the website isn't letting me upload an image. Sorry!
 
I think you mean which ICD10 gets assigned to which CPT. I can't speak to Practicode (and I am personally not a fan anyway). Practicode is not the same as actual real world experience. In the real world, it is a combination of documentation, LCD or carrier policy, basic medical terminology knowledge. Sometimes you get it wrong and have to submit a corrected claim or appeal. Sometimes the physician orders a test for which there is no medical necessity, and it won't get paid.
Sometimes this will be very clearcut in documentation: "CBC ordered due to fatigue." "EKG due to palpitations."
Sometimes you may need to check carrier or CMS policy on payable diagnoses. Good practice management systems can have this built in, or you can add individual rules. This would be included in what many call "claim scrubbing" (which does also incorporate additional things).
Sometimes you need some basic medical common sense. If the diagnoses are knee pain and back pain, the knee xray should be linked to the knee pain.
 
Thank you, all.

Noting your advice about practicode, Ms. Speroni. It was part of my program and I'll finish it; but I won't consider myself really experienced just because of it.
 
sls314 said:
If you look on this PDF of a 1500 form, you'll see that diagnosis codes go in field 17 on a professional claim form. The diagnosis pointer is under field 24-E. That's the concept Practicode is trying to replicate in the modules for professional claims.

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Aha...the diagnosis pointer. I remember that well enough, because well before I bought my CPC program, I had spent enough time looking at the CMS-1500 to have noticed the diagnosis pointer box. So diagnosis pointer = 'code linking"on practicode. Got it.
 
I already think the practicode program could have put more effort into its instructions. I pretty quickly had to have AAPC explain to me that the promised three attempts refer specifically to the assessment and not the 200 cases in the modules--I mean, I thought I could repeat each case and was trying to figure out how. Then the program left it to me to find out that "code linking" refers to the same task as getting a diagnosis pointer on a 1500. Unless that was just deliberate--e.g., they wanted the student to figure it out themselves--none of this was in the instructions.
 
The Angel Of the South said:
I already think the practicode program could have put more effort into its instructions. I pretty quickly had to have AAPC explain to me that the promised three attempts refer specifically to the assessment and not the 200 cases in the modules--I mean, I thought I could repeat each case and was trying to figure out how. Then the program left it to me to find out that "code linking" refers to the same task as getting a diagnosis pointer on a 1500. Unless that was just deliberate--e.g., they wanted the student to figure it out themselves--none of this was in the instructions.
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Exactly. When I took Practicode over 3 years ago now, there was never anything in the instructions about linking the codes. I only found out about that due to the Practicode assistance telling me after I'd already completed all the modules and was waiting for them to take off the A from my CPC certification. They, actually, asked me if I wanted to go back and link all the CPT codes to the ICD 10 codes in all the modules. I didn't do that. I might have gotten some percentage off of my total score for not doing it, but it wasn't significant enough to be considered Failed.
 
Code linking is when you link the procedure billed/performed with medical necessity. Are they wanting you to actually provide proof that you're doing so?
The Angel Of the South said:
So I started the CPC-A practicum, but quickly figured out that I'm not ready to go any further, because the module cases require code linking and I haven't learned anything about code linking yet. Is that in the codebooks somewhere? If not, where else do I look to learn it?
Click to expand...
 
In the training module video it shows an option to add extra codes before submitting your answer. It showed A, B, C and you could have more if you needed. Then it showed her "linking" those codes as she added them to her answer and submitted her case. Is that what it means?
 
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