Success Stories

Donna Beaulieu, ACS-FP, CPC, CCP, CRP, began her healthcare career over twenty years ago in the public relations and marketing arena. She started out as a certified fitness instructor (where her anatomy and physiology education began) and dabbled in patient care, performing such tasks as taking X-rays and administering modality treatments. As a favor to physician friend, she began doing some insurance billing and found that she had a love for the paperwork behind patient care and the language of coding. Since then, she has been hooked on coding, and today works as a compliance officer at Quality Physician Services, LLC in the Atlanta, Georgia area. She is responsible for fielding all coding and compliance questions, oversees staff, and provides on-going training and auditing. She also represents her company as a coding expert witness when needed.

Donna first heard of the Board at the Coding Extravaganza in 2004. A self-proclaimed “coding snob”, she became interested in obtaining her certification as a way to set herself apart as a coding guru. Excited and ready for a challenge, she signed up for the ACS-FP exam. Her nerves popped up when she finished the first page of the exam and realized it wasn’t going to be a cakewalk. Donna did pass the exam, although it took two attempts. After the first attempt, she threw herself into studying and six weeks later passed the test, earning her ACS-FP.

There have been several changes that have occurred since she obtained her ACS-FP. Her organization, Quality Physician Services, is now more aware of coding standards and guidelines and works to stay inside those parameters. As a result, the group has exceeded MGMA reimbursement and days-in-accounts-receivable benchmarks. In addition, Donna has been asked by the CEO/COO of Quality Physician Services, LLC to develop and implement a Coding Compliance Plan for the group’s seven locations. “I believe that keeping our organization on top of coding rules, regulations and changes has helped us collect what we should and has given [me] the confidence to question occasions when an insurance company may hold or deny a claim without just cause,” says Donna, who has also earned the CPC, CCP and CRP credentials.

In addition to helping her organization reclaim its rightful reimbursement, Donna has encouraged her colleagues and staff to seek certification. Her organization now provides ongoing coding and compliance training for new hires as well as mandatory continuing education for all providers and office managers.

She advises potential test takers to audit/research some patient charts, review relevant CPT sections and make sure you’re up on abbreviations and terminology.

BMSC took time to speak with newly specialty coder, Vicki Cadenhead, who earned her Advanced Coding Specialist certification in Cardiology in 2007. Read her story below!

Vicki’s coding career started in 1999, in a small doctor’s office, when her doctor gave her a chart and told her to “code it”. After doing it for a while, she decided that she liked coding and began to study diligently, learning all that she could from the resources available to her. Vicki worked her way up the career ladder and now serves as a Coding Supervisor, supervising 10 coders at a large cardiology practice with 18 locations nationwide.

Was the exam easy or hard? How did she prep for the test? Did she pass on the first try? Vicki answers the key questions of inquiring coders everywhere.

BMSC: What made you decide to “just do it” and take this exam?

Vicki: When I decided I was going to the Extravaganza, I thought this would be as good time to sit for the exam. Although I was nervous, I consoled myself by saying I know what I know. I do this all the time.

BMSC: What did you think of the exam after you took it?

Vicki: I was a little nervous after she took her exam, but she felt good about it.

I took the entire 4 hours to complete the exam. Even though I finished early, I took time to review my answers before submitting the test booklet. I thought the questions asked were asked in a manner that I am comfortable – like questions I would receive from my doctor or other coding staff.

BMSC: What was the first thing you did when you found out that you had passed the exam?

Vicki: I screamed Yoo-hoo! I was very excited. I showed my boss my results letter, certificate and pin and I show my credentials with pride.

BMSC: How has your life changed since you’ve earned your ACS credential?

Vicki: My comments now carry more weight with the doctors with whom I’m in contact with.

Also, one of my coders said “When I grow up, I want to be like you.” It’s a great feeling!

BMSC: What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?

Vicki: I would tell them…You do this all the time. You know this. Take the prep course that is given and you’ll be surprised at how much you really know. Just take the test. It’s four hours out of your life that could bring you great rewards.

Denise Chartier, ACS-GS started out as a collector at Tulane Hospital in New Orleans. After two years of seeing denial after denial due to lack of pre-certification and prior authorization, she decided she wanted to help reduce the number of denials by working in the front office. A patient account coordinator position opened and Denise was hired to handle the front-end collections and pre-certifications at Tulane’s urology and fertility clinic. After just two months, the denial rate and collections were lower and Denise had established herself in the clinic. “By this time, everyone knew you don’t do any testing or procedures without checking with Denise first,” she says.

After staying in the position for two years, Denise moved to a new challenge: surgery coding. Coding for surgery was harder than she expected and has good friends to thank for helping her through those first few months. “They walked me through so many cases, I should have given them half my paycheck!” she says.

Denise’s reputation for putting departments back on track prompted two doctors to refer her to a department billing coordinator position being created in the Tulane University School of Medicine, Department of Surgery. That was in 1999 and she still works there today, and is responsible for all of the pre-certification of all procedures performed outside of the department. In addition, she handles all of the medical and legal billing and collections for the doctors in the department of surgery.

In 2004, Denise saw a flyer in Part B News about BMSC and convinced her supervisor it would be worthwhile for her to sit for the ACS-GS exam.

By the time she got to the exam, Denise admits that she was a nervous wreck. “People go to school for years to learn all this stuff,” she kept telling herself. “I’ll never pass!” But as she opened the test, her confidence increased as she breezed through the medical terminology and procedure coding sections of the test. The lab and X-ray portions were a bit more difficult as she had never coded those procedures before. Fortunately, the good grades on her strong sections made up for the grades on the lab and X-ray portions, and she passed the test. She was elated.

What has happened to Denise since receiving her ACS-GS? She received praise from her co-workers and family, and received a nice raise. In addition, Denise finally feels as though her boss is more than confident in her coding ability. “He knows that I know what I am talking about, when it comes to coding issues,” she says. What’s the best thing that happened as a result of becoming ACS certified? The feeling of accomplishment and confidence she experiences every time she sees the certificate on the wall or signs the letters “ACS-GS” after her name. “Although I never attended college, I feel as though I’ve accomplished something with my life.”

Meet Joann Huenink, who earned her Advanced Coding Specialist (ACS) credential for Orthopedics in February 2008.

Joann’s coding story begins with her first foray into the healthcare arena -- at 17 years old. Very early on, she was intrigued by the interworkings of surgical cases and decided to go to surgical tech school. She then, was hired as a surgical tech and even spent time in the burn center after her graduation. During that time, Joann was approached by orthopedic surgeons who were impressed by her skill and commitment and encouraged her to join their practice. The surgeons got their wish! Now, with clinical and hospital experience under her belt, there was one more facet to learn. A medical records and ICD-9 coding position became available when the practices’ coder moved away, so she took it. The rest – as they say – is history. Joann fell in love with coding and billing and has been in this field for 10 years. In her current role as a Coding Supervisor for a midwestern orthopedic practice, Joann codes for the 13 surgeons and appeals all of the carrier and Medicare-related denials. Joann also frequently conducts training for the practice’s billing team and keeps the doctors up to date on all new CPT and ICD-9 codes.

Was Joann nervous about taking the orthopedic-specialty exam? Did she have test anxiety or does passing tests just come naturally to her? Did she even study for the exam? If so, how long did she study? BMSC asks Joann the tough questions that specialty coders everywhere want to know.

How did you hear about BMSC and the Orthopedic coding credential?

I learned about the Orthopedic coding credential during the Specialty Coding Extravaganza in 2006. When I heard about it, I thought it was fine, but wasn’t really convinced that I needed it because my doctors really didn’t require it [certification] at that time.

What made you decide to “just do it” and take this exam?

At the 2007 Advanced Orthopedic Coding Symposium, I thought, after being involved in the full circle of patient care for 20 yrs, “why not? I deserve this”. I wavered between the SCP level and ACS level examination, but decided to go for the ACS level examination because of my level of experience.

What did you think of the exam after you took it?

I’ll be honest. It tested me on things I wasn’t very familiar with even after several years of coding. I was very nervous about my results after taking it.

What was the first thing you did when you found out that you had passed the exam?

I told my boss and soon thereafter, added the credential to my email signature and appeal letters. My boss also sent around a memo to everyone in our practice and told everyone how happy she was that I had passed and was now an ACS-OR credential holder!

How has your life changed since you’ve earned your ACS credential?

My doctors have more respect for me. They truly respect and believe in what I say. Certification shows that you care to make things right…You are not one who gives in easily.

What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?

Let’s get something straight -- I do not test well. I studied hard by visiting the ortho listservs, past conference material, online references, practice questions, the orthopedic study guide – you name it, I used it to study. However, I learned something profound through the process. Once you start studying, other questions come up, so I learned a lot by just studying for the test. But you know what? It’s soooo worth it. I feel like I’m part of an elite family of coders. My advice is “Just do it for you!”

Tammy Hutchinson, ACS-CA began her career as an executive secretary for the Respiratory Therapy Department at Central Mississippi Medical Center. During her years there, she worked with physicians in the internal medicine, otolaryngology, pulmonary and cardiology departments. That was more than a decade ago. Today, Tammy is the insurance manager, responsible for all aspects of coding, billing and reimbursements for the Hines Cardiology Clinic, P.A. She handles the input of any charge changes or coding changes, ensures that claims are paid at the right PPO rates and that all claims are worked accordingly.

In 2003, she saw a brochure about BMSC. She was excited to read about an organization that offered certification specifically in cardiology and knew she wanted to be involved with it.

Tammy was scared to death about taking the exam. She attended the conference and sat in on Cardiology Board Lead Linda Gates-Striby’s education sessions. The test was as she had expected – easy in the areas that she coded on a daily basis and harder in the areas that she hardly ever coded. But the conference sessions helped her in the areas where she was weak, and she passed the test on her first attempt.

Since earning her credential, Tammy has seen several changes in her life, both personally and professionally. On a personal level, she is proud of her herself for setting a goal and reaching it. On a professional level, the physicians Tammy works with knew she could code even before she took the test. Since passing, however, she believes she has the ability to produce more clean claims than ever, leading her physicians to have more confidence in her as well. So much confidence, in fact, she was promoted from insurance clerk to insurance manager for her entire clinic. Her practice continues to support her career goals by giving her the time and money needed to sit for the ACS exam and to attend continuing education sessions.

Meet Sharon Klug, who earned her Advanced Coding Specialist certification in E/M Auditing in May 2007.

Sharon came into coding after working as a nurse manager in a large multi-specialty clinic. She admits that a lot of her knowledge of coding initially was “self-taught”. Then, she made it a priority to start attending coding-related conference in order to increase her knowledgebase. Her company didn’t have a formal billing department and she was asked if she wanted to participate in the development such a department. Sharon jumped at the chance! Sharon has since earned her CPC and her PMCC teaching certificate. Now, after over 20 years in the healthcare industry, Sharon is the Supervisor of Provider Coding Education for a large healthcare provider in the Midwest.

What does Sharon think about certification? What encouragement would she give anyone thinking about taking the exam? Did her doctors treat her differently after certification? Sharon takes time out of her busy schedule to chat with BMSC about what earning the ACS-EM credential has meant to her – personally and professionally.

BMSC: Why is it important for coders to have a coding certification?

Sharon: I currently teach a coding curriculum to my staff of coders. Our company identified a need for coders to become certified as a benefit to physicians and coders alike. This certification also adds a level of protection for our providers.

BMSC: How did you hear about BMSC and the E/M Auditing credential?

Sharon: Actually, I won a free registration at the Specialty Coding Extravaganza, so since I do E/M coding education and auditing most of the time, I thought that was a good fit for me.

BMSC: How did you prepare for the examination? What made you decide to “just do it” and take this exam?

Sharon: I really didn’t do a lot to prepare because I do E/M coding on a daily basis. As a precaution, I did review the documentation guidelines and asked questions about things I thought were subjective.

BMSC: What did you think of the exam after you took it?

Sharon: Overall, I thought it was a fair exam. The complexity of exam ranged from easy to difficult.

BMSC: What was the first thing you did when you found out that you had passed the exam?

Sharon: Once I learned that I had passed, I immediately called my proctor and let her know. And I quickly added the credentials after my name in my email signature.

Did your staff or doctors treat you any differently once you became certified?

Sharon: No one overtly treated me differently. However, it comes out when I am questioned regarding coding decisions with doctors or other coding staff. Earning this certification improved my self-image and self-confidence. And because of that, it gives me a more confident base to present this information to the doctors.

What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?

Sharon: I would ask them “did you take the basic first step examination, and how did you do?” I would encourage everyone to make sure that they have the foundation [coding education and experience] to be successful before taking the test. If they say they did well and if they believe they’re functioning at a higher level, then go for it!

Evelyn Kim Ma started out in the health care industry over 22 years ago. Because of her husband’s job, she has traveled the world and has worked in many roles in many health care settings. Previous positions include medical assisting as well as patient care, and eventually Evelyn settled on coding. As she says, paper is sometimes easier to deal with than people are. Today she works as a Team Lead Coder at the University of Texas Health Science Center at San Antonio, Department of Orthopedics. She is responsible for a staff of four: two coders and two clerks. She codes the surgeries, inpatient E/Ms, special clinics and general clinics, when she is needed. She is also the “go-to” person for anyone who has an orthopedic question. When she isn’t busy with all of that, she also helps to educate physicians on new codes and new changes in procedures.

Evelyn first heard of BMSC last year when her administrator showed her a flyer about the organization. The administrator offered to pay for Evelyn to take the test and wanted her to do so as soon as possible. Evelyn, however, wasn’t excited about the idea of taking another test – she felt that she might not know enough to pass as she had only been coding orthopedics for 3 years. But, she passed the test on her first attempt. “I guess I knew more than I thought!” she said.

In addition to receiving a promotion and a raise since earning her ACS-OR, Evelyn now sees changes in her coworkers’ and physicians’ behavior towards her. “The doctors pay more attention to what I say when I bring coding issues to them,” she says.

The overall result, Evelyn believes, is that her coding team is more cohesive and has a better working relationship with the physicians and administrators within her department.

Shirley Todd, ACS-GS, sent a letter to BMSC soon after earning her credential. Please read on as she relates her experiences:

When I started in this business (July 1960), there were no codes to put on charts for procedures or diagnoses. The physician just wrote down what he did. Now things are much more complicated. As you grow in this type of occupation, you understand the reason. It helps to keep track of certain types of CA, illnesses, diseases, etc. In many ways, this can become a headache.

I have been coding for many years. I was taught by one of my surgeons. I really enjoy coding. It is not only interesting, but a great challenge to see how many different codes you can use for different types of surgery. I work for four general surgeons as office manager and coder. They are very supportive of me when I want to attend a meeting.

The meeting I attended was giving an examination for “specialty coding,” (i.e., surgery, urology, ob-gyn, etc.) and I thought to myself, “I wonder if I can pass this test?” Well, I went to the Extravaganza and it was great (very intense, but I learned a lot). The test was on a Saturday and my husband and daughter (who came to the meeting with me) encouraged me daily to take this test, but I was afraid I wasn’t knowledgeable enough to pass.

Well, on Friday, I signed up for the test and thought, “I have nothing to lose and everything to gain if I pass it.” You know, when you are in the profession as long as I have been, it really means something if you find out, “Hey! I really do know what I am doing!” You feel pride in yourself if you can accomplish this certification. Well, lo and behold, I PASSED THE TEST, and I am now an Advanced Coding Specialist in General Surgery. You can’t believe how proud my family and doctors are.

I would encourage anyone in a specialty to take this exam. If I can do it, so can you! Thanks to the Board of Advanced Medical Coding people and staff.

Sheila Vanderlin, CPC, ACS-CA, CCP, started her health career in the accounts receivable department of Cardiovascular Provider Resources in Dallas, TX. When an opening came up in the coding department, she decided to apply. She got the job and has watched her responsibilities grow to include auditing and denial coding.

In 2004, Sheila had been thinking about ways to become more proficient in coding. She attended a cardiology coding seminar and saw a BMSC flyer. She decided to sign up for the ACS-CA exam and she put her thinking cap on and passed on her first attempt.

Since taking the exam, Sheila has received several benefits. “The most important thing I got out of this test was the personal satisfaction of knowing more than I thought I did. That is better than any raise or other recognition,” says Sheila. In addition, her supervisors now have more confidence in her coding, which boosts her confidence even more.

Sheila found the cardiology exam difficult, but realizes “this credential will give you more confidence in your coding.”

Kelly Dennis’ career began in 1983 in a fee-for-service billing company in Leesburg, Florida. With no medical experience or background, she began working part time as a data entry clerk/administrative assistant. “I will never forget how much there was to learn!” she says. But always ready for a challenge, Kelly embraced the ever-changing healthcare field. Throughout the next 18 years, she made the transition from fee-for-service to a management company hired to form one group of anesthesiologists, working in almost every position imaginable. In 1996, the billing was brought in-house where Kelly had sole responsibility for hiring and training the office personnel. What began as a part time job to supplement her family’s income became a lifelong career in anesthesiology coding, and today she offers her knowledge and advice to medical offices around the country.

Aside from the on the job experience she received, Kelly also attended a local community college, receiving her associate’s degree in Business Administration. In 2004, she earned her bachelor’s degree in Business and Healthcare administration through American Intercontinental University. “I distinctly remember that my medical terminology class was like learning a new language,” she says. In 1999, Kelly earned her CPC and in 2002 she passed the Professional Medical Coding Curriculum test. In 2004, she earned her status as an Advanced Coding Specialist – Anesthesia and Pain Management.

What prompted her to seek all of these additional credentials? “I believe in continuing education,” she says. She also became aware of the importance of certification during an external review of her anesthesiologists’ practice. The consultant conducting the review highly recommended that the coders in the office become certified for compliance purposes, at which point she began researching certification options.

In 2003, Kelly was consulting, and she was interested in demonstrating that she had deep knowledge specifically in anesthesia coding. It was about this time she discovered The Board of Advanced Medical Coding through a meeting she attended in Las Vegas. “BMSC recognizes the difficulty that some coders have in passing a timed test that may not apply to their specialty,” she said. “It offers these specialty coders a method to prove they are knowledgeable in their own field.”

Kelly also likes BMSC’s recertification policy. “One of the most impressive aspects of BMSC is that they require retesting on changes that have occurred [in one’s specialty] in the past two years,” says Kelly. Rather than requiring certified coders to retake the entire 4 hour exam every two years, certified coders are only tested on changes in their specialty that have occurred since their previous exam.

Kelly decided to sit for her ACSAP exam and naturally passed. Since then, she has assisted BMSC in developing and refining the ACS-AN exam. [In 2005, the Advanced Coding Specialist – Anesthesia/Pain Management was separated into two certifications – Advanced Coding Specialist – Anesthesia (ACS-AN) and Advanced Coding Specialist – Pain Management (ACS-PM).]

What advice does Kelly have for fellow coders? “I believe people MUST have knowledge in their area. Whether it is the physician who codes, or an employee who codes on behalf of the physician, there is an inherent responsibility to submit correct and appropriate claims.”

Kelly Dennis, BBA, CPC, ACS-AP, has been a BMSC board member since January 2004, when she helped develop our original anesthesia and pain management certifications. She has since provided invaluable advice and input into the creation of the ACS-AN exam and certification development. Kelly is president of Perfect Office Solutions, Inc. a billing and compliance auditing firm based in Leesburg, Florida.

Before Debra Rossi became a coder, she worked in the legal profession specializing in health care. She worked with a physician who had great vision about the future of health care regulation. This piqued her interest in coding and compliance, and she was encouraged by her physician to further her education in these areas. Today, Debra oversees the auditing and training of over 800 physicians on documentation and coding guidelines in all specialties.

Debra first heard of BMSC at the First Annual Coding Extravaganza in 2003. After doing some research, she felt that while general coding certifications are a great place to start to further a coding career, the BMSC exams are a validation of a certain level of expertise in various coding specialties. So, confident in her coding knowledge, she decided that the family practice exam was for her and looked forward to the challenge of the test.

What did she think of the test? “The exam was not easy, but it was fair,” she says. The test required her to use her experience in family practice and covered all areas she would be expected to code for on the job. She passed on her first attempt, and now feels a sense of personal accomplishment by earning the ACS-FP, in addition to her other credentials: CCS-P and ACS-MS.

Since earning her ACS-FP, Debra’s career has taken off. She has been able to advance and continues to take on new responsibilities, including hiring and overseeing the education of new coders and compliance analysts. She has also published several coding and compliance articles and has spoken at various national conferences. “My certifications have assisted me in becoming recognized as the resident ‘expert’ in coding.” she says.

Debra’s certification has encouraged her organization to offer a comprehensive coding and compliance program/resource to physicians and staff. As a result, many employees at NSLIJ (North Shore/Long Island Jewish Hospital) want to further their coding education, and Debra is able to offer advice on the career paths to follow. “Although [coding] is a respected profession it is not a well publicized profession. Education is the key to letting prospective employees know what their opportunities are. With increased interest in continuing education in coding, we can encourage current and future coders to strive toward certification and promote within our system.”

Finally, Debra has some advice for coders considering their certification. “This certification is not for beginner coders. You need to have experience in your specialty and confidence in your knowledge of that specialty,” she says. She advises coders to keep up on the latest coding and documentation regulations and guidelines, use the test outlines provided by BMSC and, if possible, attend a review session offered by BMSC board members at conferences prior to the exam.

But all in all, “go for it!” she says. “It is a stamp of excellence that will give you both the professional recognition you deserve for all of your hard work and dedication, and personal satisfaction for a job well done,” she says.

Margie Scalley-Vaught first began her career in healthcare as a nurse’s aide at the age of 16 in a local nursing home. She has held positions in the healthcare arena ever since, including medical records clerk, ward clerk, hospital transcriptionist, office manager, auditor and trainer and consultant in the office and hospital settings.

Throughout the years, she was sure she could help build her career and credibility by sitting for credential exams, including the CPC in 1995 and the CCS-P in 2000. “Getting the CPC in 1995 was a wonderful feeling,” she says. “But I wanted to continue to test myself to see if I was still learning and understanding.” She wanted to see if she was still understanding and applying the guidelines and rules appropriately. Her certifications now take up several lines on a business card: CPC, CPC-H, CCS-P, MCS-P, ACS-EM and ACS-OR.

Around 2000 is when Nancy Maguire asked Margie to sit in on a meeting about a new specialty coding organization (BMSC) at an Extravaganza in Florida. Margie felt that a specialty exam that allowed for continued knowledge and growth was the next natural step in her coding career.

Always wanting to push herself, Margie decided to sit for both the ACS- EM and the ACS-OR, even though she confesses she “HATES” tests. “I know that might surprise some people when they see the credentials behind my name,” she says, “but trust me, I HATE tests! Each time I have taken [certification] tests I have always left asking, ‘Okay, when can I take the retest?’ They always remind me of those hateful SATs or, even worse, those dreaded typing tests where they make you type sentences that make no sense as fast as you can just to see how many words you can type in a minute. Whenever they said ‘start’ my fingers could never find the keys.”

Despite her nerves, she passed both exams and today works as an independent consultant. She is in a unique situation in that she doesn’t have a supervisor per se, but earning the ACS-OR and ACS-EM in addition to her other credentials has built up her confidence and has allowed her to network with others who have taken the ACS exams. It also helps her clients to realize that she is continuing to test herself and that she values the importance of knowledge and education.

What advice does Margie have for others considering taking an ACS exam? These specialty exams test you in terminology, anatomy, ICD-9 coding, E/M coding, modifiers, procedure notes, Medicare issues and even how to fill out a CMS 1500 form. If you are taking a surgical specialty credential, you should also make sure you understand terms, anatomy, abbreviations, etc. It is also important to understand billing issues. For the E/M, it is important to read through the 1995 and 1997 documentation guidelines (although they are supplied to you during the test).”

Margie tells fellow coders to “Just DO IT!!! – DO IT!!” She emphasizes that certification helps your supervisors/providers to know that, as part of the team, “you will always go the extra mile and make sure that you are keeping them out of harm’s way.”

My name is Jen Noel, HCS-D. I passed the exam this month. This was not the first time I took the exam. I tried once after a workshop and I tried again for the free fee. I felt confident before taking the exam the first time. My knowledge came from a fellow co-worker. I did not investigate too much on any education until the first workshop for beginners I went to. It was given by Sparkle Sparks. What a great teacher! I attended another workshop at Penn State and the following day preceeded to take the certification exam. Everyone was so supportive at work but little did we know that I did not have enough education to sit for this exam. I did have the study guide, but did not completely get through the book before taking the exam nor did I have a true understanding of home health coding. I became involved in a coding forum and took the test again (for free) in my office. I only had maybe a 1 - 1 1/2 years experience at this time. When I completed this exam, my supervisor asked my how it went. My reply was that I was still learning more while I was taking the exam, which led me to believe that I would fail again. This was very frustrating. And I did, indeed, fail again! I became more involved in learning the whole aspect of coding and learning from fellow coders on the forum and workshops/ teleconferences. The discussion on the forum was time consuming reading this data, but was very helpful. I attempted to read this forum every day through the week before I started my coding process. This time when I took the exam, the only individuals who knew I was taking the exam were my proctor and myself. I said my prayers that morning asking for help to achieve passing this exam and for confidence in taking the exam. I took the exam on-line this time. What a great benefit!!! This is a definite asset to coders who wish to take the exam! Getting the results right away was great! I could talk myself through any question aloud without disturbing anyone! I believe I was more comfortable in this setting also! I posted a note "Please Do Not Disturb" and I got started with my proctor. None of my co-workers disturbed my, which was great! I completed the exam with 45 minutes left. I went back only to check two questions I wrote down to go over again and I had to talk myself out of checking any more questions. I felt confident since I had more experience. The suggestion of having at least 2 years of home care coding experience before taking the exam, I now understand, was to my benefit!! What a difference the extra education was! I passed with an 85%! I got the results immediately once I pushed the submit button. I wanted to shout for joy!! I did it!! What an achievement!!!

Coding will be an ongoing learning process each and every day! So many scenarioes! So many changes each year! But I look forward to the challenges. I went back to the forum the next day and thanked everyone for sharing their knowledge because I do believe that helped me alot. It's great to have these people in the forum, the workshops, and teleconferences sharing their knowledge and having such patience in answering the same questions over and over again. That and working on scenarioes whenever I had the time!!! I thank God and everyone from the forum and the workshops/teleconferences for sharing their knowledge and understanding in the puzzle of home health coding!!!

Kay Stairs, RN, HCS-D, began her career as a critical care nurse but made the switch to home health about five years ago. Kay currently works as the Director of Professional Services for Angleton Visiting Nurses in Angleton, Texas, where she wears many hats. “My most important responsibility is to ensure the Plan of Care is being followed on all of our patients,” she says. Other responsibilities include coordination of care between field staff, office staff, patients and the physician. Finally, she performs QA before every start of care, recert and post hospital oasis for accuracy and coding.

Kay first learned of The Board Of Medical Specialty Coding through an ad in a home care magazine. She attended a conference where the Home Care Coding Specialist – Diagnosis (HCS-D) certification exam was being offered. Kay decided to stay the extra day to get her HCS-D certification.

She says she found the exam thorough and challenging, but thanks to a college textbook she had, she was able to study some beforehand to brush up on the coding basics. She found the medical terminology section to be the toughest, but was able to draw on her hard work and hours of on the job study to get her through the exam.

Needless to say, Kay passed the exam with flying colors and now proudly displays her credentials after her name. And what has happened as a result of her HCS-D? “I got some praise, and more responsibility,” she says.

Today, Kay continues to implement practices that ensure her organization gets correct reimbursement. She knows that persistence, diligence and not taking the easy way out not only ensures her organization gets the reimbursement they are fairly due, but keeps the auditors happy as well.

What advice does Kay give to other coders? “Do it. Don’t take [the HCS-D] exam without studying. Practice, Practice, Practice!”

We at BMSC congratulate Kay Stairs, and all other coders who have sat for and passed the HCS-D exam.

After graduating University of North Carolina-Charlotte in 1997 with a Bachelor’s of Science in Nursing, Cheri Turner, BSN, RN, BC, HCS-D spent two years in a hospital kidney and liver transplant unit. Although she developed a multitude of technical skills, patient communication skills and critical thinking skills, it wasn’t quite the career she was looking for. “The physical toil of 12 hour shifts, providing care to eight patients at a time, and delivering care dictated by a physician with minimal input was not only exhausting, it did not provide the personal fulfillment I desired,” she says.

With the encouragement of a friend, she ventured into the field of home health nursing. She began as a case manager at a hospital-based home health agency, and later moved into the role of Medicare Coordinator and OASIS specialist. She found that working with patients in their environment, developing a partnership with the patient and truly becoming the patient’s advocate was the personal fulfillment she hadn’t found elsewhere.

In 2002 she moved to a privately owned home health agency, where she oversaw a team of clinicians who delivered direct patient care.

Today, Cheri works for Total Care Support Services and is responsible for the orientation of clinical managers as well as instruction in OASIS, Medicare documentation guidelines, ICD-9 coding and management of services under PPS for the organization’s 15 branch offices. “This role continues to provide opportunities to improve the quality of health care to an even larger patient population through staff development, appropriate reimbursement and utilization of service.

Cheri first heard of the Board Of Medical Specialty Coding and the HCS-D certification through the Clinical Supervisor’s Alert, a DecisionHealth publication. After having developed a coding class for Total Care Home Health Services, she felt it would be advantageous to obtain the HCS-D certification and validate her ability to provide instruction to others. However, she hadn’t had any formal education in coding, and was a bit anxious about taking the exam. “I attended the coding Seminar before testing and during the seminar I realized that I did have a lot of accurate knowledge regarding the subject. This helped to alleviate some of the anxiety and improved by self-confidence,” she says.

Since receiving her HCS-D, Cheri has received quite a bit of recognition from colleagues and supervisors and has been given additional responsibilities. She is often asked to review coding at various branches of her agency and is now responsible for the education of coding staff. There has been an overall increased accuracy in coding and improvement in her organizations HHRG scores since obtaining her HCS-D certification and providing coding instruction to her agency. Patient care plans and utilization of service have also improved.

Lisa Selman-Holman, JD, BSN, RN, CHCE, HCS-D, COS-C began her career as a pediatric nurse in 1986. She soon “graduated” to Medicare field nurse before becoming a case manager and eventually a director for private duty agencies. In 1990, her career changed directions when she decided to attend law school. However, the law couldn’t tear her completely from home care – she continued to work as a home care nurse while she was in school. After graduation, Lisa was offered a position as attorney in the Texas Attorney General’s office, but decided that home care was where her heart was. So, she began working with the Texas Association for Home Care as Director of Regulatory Affairs and Clinical Practice, where she was involved in regulatory work. She spent 9 1/2 years as Vice President of Legal Affairs for a home health management company where she provided in-house legal services and consulting for certified and non-certified home health, hospice home infusion and DME.

Today, Lisa owns her own home care consulting and education company, Selman-Holman & Associates, LLC. She integrates her home health experience and legal expertise by advising clients on the basics of home care, coding, OASIS, billing and laws that affect home care. She acts as an advocate for state agencies, the intermediary and CMS. She develops policies, creates draft contracts and performs corporate filings, coding audits and mock surveys. She also works with startups and provides assistance with Plans of Correction.

Lisa first heard about BMSC when the HCS-D credential was announced in 2003. At that time, she had been teaching home care coding for a couple years, and was excited to hear about the certification. She not only decided to sit for the examination, but decided she wanted to become a board member as well.

Although she is often teased about her credentials taking up two lines on her business card, Lisa is quite proud of her HCS-D and continues to reap the benefits. “I don’t think that I would have the credibility as a home care coder that I have now,” she says. In addition, her certification has sparked a lot of peoples’ interest in getting certified. However, earning the certification doesn’t mean that people are finished with their education. “Those who have earned the HCS-D must strive for even greater knowledge,” she says. Accordingly, Lisa works with BMSC, state associations and private companies in getting home care professionals certified by providing the education necessary and the opportunity to take the exam.

As for the future, Lisa looks forward to working with BMSC as a member of the HCS-D advisory board for home care coding to establish a more advanced competency in home care coding. “Coding is very technical and we are learning more about the intricacies involved in home care coding,” she says.

And, because Lisa is so involved with the HCS-D exam and educating her clients on home care coding, she has very specific tips for those who are considering or have registered for the exam:

1. Download the official coding guidelines and read them.
2. Download the CMS diagnosis examples from the Internet and read them (the coding manual published by DecisionHealth has included the CMS diagnosis examples). Highlight, underline—do what it takes for you to have a pretty good understanding prior to attending the class. That way you will not be completely lost and will be able to apply what you have already learned by reading the official guidelines.
3. Consider reading the PPS rules, especially if you don’t have a good understanding about the case mix system and the case mix diagnoses. Bring your book to class—so many people come without a coding book to a coding class. And be prepared with post-its, highlighters, etc. for making your coding book more useful by tabbing the different sections and those commonly used codes, e.g. diabetic codes. That will be important for moving through the book rapidly during the exam.
4. Start at the back and work forward. That way you will have the sequencing questions ‘under your belt’ when you are tired and may be running out of time.”

Sparkle Sparks, MPT, HCS-D, COS-C began working in home health over ten years ago as a physical therapist (MPT) after having worked in the acute care and inpatient rehab settings. In 1999, a friend asked her to give a therapist’s perspective when analyzing their organization’s data to apply it to a new reimbursement system called PPS. Little did she know that this “temporary assignment” would slowly eat into her patient care time until she became the agency’s OASIS and ICD-9 coding analyst/instructor. This, of course, was in addition to her role as clinician and therapy liaison.

Over the next few years, Sparkle put a lot of pressure on herself to learn coding. “I was very insecure about my coding abilities,” says Sparkle. “I had some wonderful, generous mentors and I used to drive them crazy, I’m sure, with all of my questions.”

During this time, Sparkle attended several conferences to ensure that she was up to date on the latest in coding. It was through these conferences where speaker and board member Prinny Rose Abraham and Sparkle became friends. Prinny told Sparkle about this advisory board that she was a member of (BMSC) and how they were developing a home health coding credential. Sparkle wanted to prove to herself that she really was interpreting the coding guidelines correctly, and decided to sit for this new HCS-D exam.

And what did she think of the exam? “Everyone’s going to hate me for this,” she says, “but I didn’t find it to be too bad. I finished it and knew that I had nailed it.” She feels that the key to her success was the tons of practical coding experience she had from her agency. She spent lot of time studying official coding guidance to make sure she hadn’t overlooked anything when she coded scenarios she wasn’t very familiar with. This is one subject where going to the source is key, as well-meaning interpretations can really wreak havoc.

In addition to proving to herself that she in fact was interpreting the coding guidelines correctly, she was also able to use the HCS-D to move back to northern California. The invaluable experiences she gained at her agency along with the HCS-D and the COS-C allowed her to transition into consulting. Today, she works as an associate consultant for OASIS Answers. Every day is different for her – she primarily does audits or training related to ICD-9 coding, OASIS or therapy utilization & management for individual agencies, state associations or industry conferences.

What advice does Sparkle have for others considering sitting for the HCS-D exam? “Get lots of practice and become familiar with coding conventions and guidelines. Develop good coding habits – don’t take shortcuts and follow all the steps required to accurately code. These are truly the keys to success for the exam, and more importantly, for accurate coding.”

“I love coding. It’s like a complex crossword puzzle. But with lots of study and practice, one can become proficient at it and earn even an HCS-D. I also love to teach and feel blessed that I am able to fly around and meet lots of people doing what I love.”