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When you receive your doctor’s bill in the mail, it may look like you have a math problem instead of a health problem. Every diagnosis and service rendered at your appointment is listed in detail along with a series of numbers that may as well be a foreign language.
These numbers - known as diagnostic codes - aren’t chosen randomly by the doctor’s office to confuse patients. They are, in fact, very important in charting your problem and may be even more important in figuring out how much of the cost your insurance provider will cover.
UL Lafayette faculty members Anita Hazelwood and Carol Venable know all about this coding system. They know the set of numbers for an appendectomy. They know the set of numbers if you break your big toe.
They also know how to explain this code to Health Information Management professionals in a manner that is easy to understand. Two of their recent training manuals garnered each a Legacy Award from the American Health Information Management Association for doing just that - providing informative information and ideas in a clear, concise manner.
“Both of their recent publications are an easy read for office employees while maintaining appropriateness for HIM course instruction,” according to the AHIMA. Industry professionals agree and have made these training manuals top sellers in the HIM field.
“In order for health information management professionals to use the coding system, they must understand the guidelines that have to be applied,” said Hazelwood, HIM associate professor. “They’ve got to know the coding system and why you pick one code over another. Our manuals explain these guidelines and give examples of the most often occurring cases of miscoding.”
Venable explained that proper coding is a necessity for correct insurance reimbursement. “So much of insurance reimbursement is tied to coding,” said Venable. “Proper coding ensures proper payment and helps prevent billing fraud.”
Hazelwood and Venable received Legacy Awards during the association’s annual Triumph Awards ceremony for ICD-9-CM Diagnostic Coding and Reimbursement for Physician Services and Basic ICD-9-CM for Physician’s Office Coding.
They were two of only six HIM professionals honored nationally for their contributions.
“It’s very humbling to be recognized by one’s peers,” said Venable, head of UL Lafayette’s Health Information Management Department. “It’s a huge honor.”
Each year, the pair tackle the issue of updating the manuals. Because diagnostic coding changes constantly, updating is mandatory.
“Each year, additional codes come out,” said Hazelwood. “So we have to include these additions in each new edition we author.”
The pair noted the new codes are very reflective of what’s happening in the world at the time. “New codes for this year included bioterrorism, Anthrax and West Nile Virus,” said Venable.
Both faculty members have teamed up again to write a preview manual for the latest coding system - ICD-10-CM - which could be implemented as early as 2005.
The AHIMA described the new book as a practical introduction to the new system. “In many ways, ICD-10-CM will be a huge improvement over ICD-9-CM, but implementation will require extensive training for healthcare professionals and coding professionals and students alike,” according an AHIMA review. “(This book’s) expert authors provide a useful way to introduce the system into the workplace with a variety of training and presentation options, including fact sheets, slides and chapter reviews.”
Bradd Clark, dean of the College of Sciences, isn’t surprised by the high praise for Hazelwood and Venable.
“We’ve known for years that Carol and Anita are outstanding leaders in their field,” he said. “But, an award from your peers is always the warmest accolade of all.”