Lisa Francis

Selected and assigned codes from ICD, CPT, and HCPCS for accurate documentation of patient care. Assigned codes to outpatient patient care encounters, ensuring comprehensive coverage of health care services at VAMC. Utilized extensive coding expertise to navigate complex patient encounters, ensuring precise code selection. Applies advanced knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection.

Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management (E/M) code to ensure ethical, accurate, and complete coding. Applies codes based on guidelines specific to certain diagnoses, procedures, and other criteria (in outpatient settings) used to classify patients under the Veterans Equitable Resource Allocation (VERA) program that categorizes all VA patients into specific classes representing their clinical conditions and resource needs.

Assists facility staff with documentation requirements to completely and accurately reflect the patient care provided. Provides technical support in the areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing. Ensures provider documentation is complete and supports the diagnoses and procedures coded. Directly consults with the professional staff for clarification of conflicting or ambiguous clinical data. Reports incorrect documentation or codes in the electronic patient health record.

Conducts re-reviews of codes abstracted for outpatient encounters identified by the VERA committee to determine if based on the documentation the specific VERA coding requirements were followed; corrects coding as needed to ensure proper patient classification in the VERA program.

Utilized references including International Classification of Diseases (ICD-9), American Medical Association Procedural Terminology (CPT), and Health Care Financing Administration Common Procedure Coding System (HCPCS) for accurate coding.Physician's Desk Reference.

Knowledge of medical terminology, anatomy and physiology.

Performs qualitative analysis of the records to ensure accuracy, internal consistency and correlation of recorded data.

Assures medical/legal requirements, Joint Commission Accreditation Healthcare Organization(JACHO) standards are met.

Ensures that coding is performed in a manner which allows input of data into the computer system.

Analyzed record information and abstracted significant data to create cover sheets summarizing healthcare services rendered during each admission.

Enters all Outpatient/inpatient clinical data, corrects outpatient/inpatient error reports. Software used: Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), Coding Compliance Editor (CCE), ESSENTRIS & HAIMS (Healthcare Artifacts and Image Management Solution).

Communicated medical records information to providers and clinical staff to capture potential Relative Value Units (RVUs).

Maintain a 95% and above Coding Audit Record Application (CARA).

Knowledge of DOD coding guidelines, Federal/State compliance regulations.

Skilled in oral and written communication sufficient to prepare comprehensive reports to make presentations of findings and recommend corrective action, and effectively interact with hospital personnel and professional organizations.