CALIFORNIA MEDICAL ASSISTANT KNOWLED GE IS WER PO GT H ● EN C M A A STR UNITY IS SEPTEMBER/OCTOBER 2011 WHAT’S INSIDE Published Bi-Monthly by the California Medical Assistants Association, Inc. for Medical Office Professionals PRESIDENT’S MESSAGE CMAA and You Can Make A Difference! t is appropriate that I chose a “bird theme” for my year of serving as your President as the time is really FLYING BY! I have been very busy with travel and promotion of CMAA. I ■ PRESIDENT’S MESSAGE ..............1 ■ TOP SECRET: Food for Thought.......................3 ■ FALL CONFERENCE 2011: Educational Speakers Schedule .....4 San Marcos & CSUSM ................5 Ways & Means .........................9 ■ EDUCATION DAYS SACRAMENTO REGION: Meeting Schedule Update ............6 ■ CERTIFYING BOARD UPDATE: Newly Certified California Medical Assistants ..................7-9 I have just returned from a two week trip to Mexico where I had the privilege to help build two homes, play with the kids at the orphanage and help serve breakfast to children who live in the retired Tijuana dump. It is an amazing trip that I have made many times and I am never ready to come home! You should see the smiles on the children when we fill four eight foot gutters with ice cream and all the trimmings to make a giant sundae. It is a mess, but so fun! continued on page 2 Kate & Mike Logan take photo with local boy. ■ CONTINUING EDUCATION: NCCI - What It Is and Why It Matters ....................10-12 Self-Assessment Test................14 Article Order Form ...................15 ■ TRIWEST PROVIDER SERVICES: Social Security Numbers and Military ID Cards .....................13 ■ 2012 COMING ATTRACTIONS.........16 ________________________ CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC. P.O. Box 5694 Petaluma, CA 94954-5694 Toll Free 1.888.464.2622 Fax 208.730.3763 Children getting ready to enjoy the giant ice cream sundaes. www.cmaa-ca.org Email address: cmaahq@aol.com CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 1 California Medical Assistant PRESIDENT’S MESSAGE continued from page 1 EDITOR VICKEY MARTINEZ, CCMA-C Riverside Region P.O. Box 2931 Riverside, CA 92516 Email: Vmartin1519@charter.net P U B L I C AT I O N C O M M I T T E E HARRIETT TOSE, CCMA-A Sacramento Region KRISTINE ONSTINE, CCMA-A Redwood Region KATE LOGAN, CCMA-AC Sacramento Region Certifying Board Administrator C O O R D I N AT O R JANICE SAMS, CCMA-C Redwood Region CMAA PRESIDENT KATE LOGAN, CCMA-AC (530) 295-1512 Email: katelogan.cmaa@gmail.com For Advertising contact: CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC. at CMAA, INC. P.O. Box 5694 Petaluma, CA 94954-5694 Toll Free: 1.888.464.2622 Fax: 208.730.3763 Email: cmaahq@aol.com www.cmaa-ca.org Material contained herein may NOT be used without the permission of the California Medical Assistants Association, Inc. ALL ITEMS FOR PUBLICATION SHOULD BE SENT DIRECTLY TO THE EDITOR. California Medical Assistant — NEXT ISSUE — NOVEMBER/DECEMBER 2011 (Above) Photos of some of the beautiful children we meet on our trip to Mexico. I am still working on a medical mission trip for Medical Assistants to sponsor a health faire for the community of La Mision or one of the surrounding communities. I mentioned this in my last message and it is still in the works. Are you interested in coming along? Let me know! The Fall Conference in the San Diego area is fast approaching (September 8 – 11). I hope you have sent in your registration. KNOWLED GE CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC. IS GT H ● EN C M A A STR WER PO Email Address: vmartin1519@charter.net DEADLINE: October 1, 2011 All materials must be submitted by the deadline date to be included in the next issue! 2 I have asked each member of CMAA to participate in MAKE A DIFFERENCE DAY! This is an event that is held annually on the fourth Saturday of October. Millions of Americans rally into a single day of action to help change the world. Find a need in your community and plan a project. I hope that each Region is working on something special. If you are continued on page 4 To submit items to be published in this newsletter, please mail or email: Vickey Martinez, CCMA-A 3181 Tangerine Way Riverside, CA 92506 The committee is working hard to provide a great meeting. M I S S I O N S TAT E M E N T UNITY IS The purpose of the California Medical Assistants Association, Incorporated, is to promote the professional and educational growth of medical assistants. CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 PRESIDENT-ELECT ’ S MESSAGE Do we listen to our patients and co-workers? As a Medical Assistant we must be able to listen to both verbal and non-verbal communications. Here are some suggestions to enable all of us to be a better listener to our patients and co-workers. • Listen to the main points in the discussion. • Attend to both verbal and non-verbal messages. • Be patient and nonjudgmental. • Do not interrupt. • Never intimidate your patient. • Use active listening techniques: restatement, reflection, and clarification. How to become a better listener: Honestly evaluate your personal biases. What do you find unacceptable in people? Do you prejudge an individual based on his or her affiliation with a particular group, or because of a certain lifestyle decision? Do these biases create barriers to the development of therapeutic relationships? If so, how can you get beyond these barriers? Remember; as you may judge others, they too judge you. Always put your best foot forward and treat others as you would want to be treated. Learn to be a better listener. Submitted by Randy Geddings, CCMA-AC President-Elect CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 3 C A L I F O R N I A M E D I C A L A S S I S TA N T S A S S O C I AT I O N , I N C . KNOWLED GE IS continued from page 2 H ● EN in a Region that is not active, consider getting some friends together and do something. For ideas you can visit the WER PO C M A A STR GT PRESIDENT’S MESSAGE UNITY IS FALL CONFERENCE 2011 “Fly South for Some Tweet Education” California State University SAN MARCOS, CA September 8 – 11, 2011 Educational Speakers MAKE A DIFFERENCE DAY website at www.usaweekend.com/section/MDDAY /Make-A-Difference-Day. You can “friend” them on Facebook or join their Twitter (@mdday) to TWEET your plans for this year’s event using the #mdday11. DATE & TIME FRIDAY, 9/09/11 8:00 am 8:45 am - While a good Medical Assistant makes a difference each day at work, let’s meet the challenge of going a step further on October 22nd! And don’t forget to let me know what you are doing to help others! I would love to report all of your great ideas to our membership! See you all when you “FLY SOUTH FOR SOME TWEET EDUCATION” at the 2011 Fall Conference.❧ NAME OF FUNCTION Registration opens at McMahon House 9:45 am Medical Reserves – Pauline Thomas ..............Basic 1u 10:15 am - 11:15 am Juvenile Diabetes – Research Foundation.......Basic 1u 1:30 pm - 2:30 pm California Medical Foundation.......................Basic 1u 3:00 pm - 4:00 pm CCBMA- Beta Testing ...............................Clinical 1u SATURDAY, 09/10/11 8:00 am Registration opens at McMahon House 8:15 am - 10:15 am Holistic Medicine – Dr. Katiraei .....................Basic 2u 11:00 am - 12:00 pm Speaker TBA..........................................................* 1:15 pm - 3:15 pm Dr. Shafai – Childhood Obesity .....................Basic 2u SUNDAY, 9/11/11 8:00 am - 9:00 am Speaker: TBA.........................................................* 10:00 am - 11:00 am Mandated Reporting Updates – Lt. Timothy Salas ...Basic 1u Kate Logan, CCMA-AC President 11:15 am Closing Business Session for Members and Guests California Medical Assistants Association, Inc. 4 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 SAN MARCOS L CALIFORNIA MEDICAL A S S I S TA N T S ocated in the beautiful foothills of northern San Diego County is San Marcos. From miles of trails in the local hills, to unique dining and shopping opportunities in its retail centers, San Marcos has all the ingredients that make visiting enjoyable. Just a 35-minute drive south takes you to downtown San Diego, while a short jaunt west across north county takes you to the majestic shores of the beautiful Pacific Ocean. A S S O C I AT I O N , INC. - FA L L C O N F E R E N C E 2 0 1 1 The California State University San Marcos (CSUSM) is a new kind of CSU — fully engaged in its community, technologically sophisticated, and dedicated to teaching future generations through a relevant curriculum with a global perspective. What makes CSUSM so special? • High quality, close instruction at three colleges and a school of nursing • Accessible faculty — 100% of full-time faculty hold Ph.D.s or the highest degree in their field • A technology-rich campus — the entire campus is equipped with high-speed Wi-Fi Internet access, and numerous “smart” classrooms offer advanced multimedia equipment as a teaching and learning tool • A fun campus — more than 80 student clubs and organizations, the Clarke Field House and an active Associated Students, Inc. • An expanding campus — current construction projects include a state-of-the-art Social & Behavioral Sciences building, a parking structure, and a public safety building. • A beautiful campus — 304 rolling acres nestled into the foothills above the City of San Marcos, and a short distance to the beaches of the Pacific Ocean and the Mexican border CSUSM is conveniently located in North San Diego County — only a short drive from the City of San Diego, Riverside County, and Orange County. The campus is easily accessed from Interstates 5 and 15. For driving instructions, visit http://www.csusm.edu/guide/ For parking information, visit http://www.csusm.edu/guide/parking.html Home to Palomar College and California State University San Marcos, the City has also become the heart of education in San Diego North. A dedication to parks and community services is another priority for the City of San Marcos. In addition to its rich recreational and cultural programs for children, teens, adults and seniors, the City has constructed and opened an additional five new parks over the past few years – bringing the total number of parks in San Marcos to 17. Quality centers like Creekside Marketplace, Nordahl Center, Grand Plaza and Old California Restaurant Row have all become popular shopping and dining destinations, and plans for thoughtful future developments like the San Marcos Downtown Creek District, Palomar Station and University Village will quickly put San Marcos on the map as a regional shopping, dining and entertainment destination. CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 Community theatre, music and fine arts organizations are also alive and well in San Marcos. The City’s own “Theatre West” group presents outstanding community theatre productions, while the California Center for the Arts in Escondido and the Performing Arts Center at Palomar College both bring entertainment of high acclaim to the local area. For more about San Marcos, visit http://www.ci.san-marcos.ca.us/ 5 C A L I F O R N I A M E D I C A L A S S I S T A N T S A S S O C I A T I O N , I N C . Sacramento Region Education Days Recently, Sacramento Region has decided to make some changes in their meetings. We are now meeting quarterly, on Saturdays, and having two speakers to still meet our goal of 8 CEU’s a year. We would like to invite the surrounding area regions to join us for our FREE education days. Please send an email to our President Anne Conway at Anne_m_conway@hotmail.com or Lisa Milosevich at lmiloccma@yahoo.com so we will know how many people to expect and can have enough refreshments and CEU’s printed. We hope to see you there! OUR FUTURE MEETING DATES ARE: SEPTEMBER 17, 2011 2 Administrative CEU’s NOVEMBER 19, 2011 2 Basic CEU’s Education will start promptly at 9:30 am and be completed by 11:30 am. We meet at National Career Education at 11080 White Rock Road, Suite 100, Rancho Cordova CA 95670. You can get directions at www.nceschool.com or www.mapquest.com. 6 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 C E R T I F Y I N G B O A R D U P D A T E Congratulations to the newly California Certified Medical Assistants Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical NAME AL ASAD, MUWAFAQU ALONZO, AMANDA ALONZO, RANDI JEAN ALVAREZ, JESSICA ZEPEDA ANDREAZZI, SHARON ANDREWS, DELAINA JO ANGUIANO, GLORIA • ARANDA, JUSTINE AVILA, FRANCES G. AVINA, MARIAH CHRISTINE AZZAM, AMNA BAIONI, RAMONA ANTONIA BAKA, LYUDMILA BAKER, REBECCA • BALA, MONIKA JANINA BARNES, CANDICE A. BARRETT, JILLIAN BARRETT, REBECCA ANNE BELLUOMINI, SUSAN MARY BLOCH, SARAH E. BOGERT, MELANIE BONILLA-DURAN, LORENA BRAND, JULIANNE BRAZENEC, MICHELLE LYNN BROOKS, KARLIE BROOKS, WHITNIE DANIELLE BUCKLAND, BRITTANY BUDNOVICH, JOY MARIE BYLIN, JULIE CALDWELL, SANDY CANO, MARIA • CARTER, CHARINA C. CASTRO, LINDA CHALLGREN, AMBER L. CHENEY, TRACY LYNN • CONTRERAS, CHRISTINA CONWELL, RHONDA • COOK, LINDA N. CORTES, ELLIZON MARLON S. CORTES, LETICIA ELIZABETH CRUZ, ANABEL CURRY, KIMBERLY DA VAULT, MELISSA DALLA VALLE, JENNIFER DANIELS, CYNTHIA • DARNELL, SUSAN DASSOW, NATASHA L. DAWSON, SANDRA D. DELA CRUZ, LIDUVINA L. DENTINO, GRACE MARIE DORST, PAMELA M. DREWS, CIDNE E. DUERRE-MULLANY, SHERI D. SPECIALTY AC AC AC C AC AC A C AC AC C C AC C C C C AC C AC C C AC AC C AC C C AC AC C C AC AC AC C AC AC C C C AC AC AC A A AC C AC AC AC AC AC HOMETOWN NAME CAMPBELL, CA AROMAS, CA MEADOW VISTA, CA STOCKTON, CA ROCKLIN, CA UKIAH, CA HAYWARD, CA VALLEJO, CA DOWNEY, CA MIDDLETOWN, CA DALY CITY, CA SOUTH SAN FRANCISCO, CA CITRUS HEIGHTS, CA WATERFORD, CA GLEN ELLEN, CA SANTA CLARA, CA REDDING, CA ROHNERT PARK, CA SAN BRUNO, CA PLACERVILLE, CA BRENTWOOD, CA STOCKTON, CA WESTMINSTER, CA REDWOOD CITY, CA RIVERDALE, CA MURRIETA, CA SAN JOSE, CA LAKE ELSINORE, CA SACRAMENTO, CA PLACERVILLE, CA WATSONVILLE, CA ANAHEIM, CA VINA, CA HUNTINGTON BEACH, CA PETALUMA, CA BAKERSFIELD, CA SELMER, TN FORESTHILL, CA DALY CITY, CA SAN FRANCISCO, CA LOS GATOS, CA PLACERVILLE, CA VALLEY SPRINGS, CA UKIAH, CA VACAVILLE, CA SAN CARLOS, CA SAN DIEGO, CA PLACERVILLE, CA SAN DIEGO, CA PASO ROBLES, CA MT. SHASTA, CA EUREKA, CA CERES, CA ECKERMAN, NANCY A. ELLENBARGER, KRYSTAL A. ELU, KATHLEEN EVANGELISTA, CRISPIN FELDMAN, LISA FELIPE, ANGELA FIELD, BRITTANY C. FLORENCE, CRYSTAL G. FRAME, KAREN LYNNE FREEMAN, WENDY LEE GALDAMEZ, JEANETTE D. GALE, SUZANN • GALEANA, MICHELLE A. GAMBOA, MELISA GANNON, ROBERTA • GARCIA, LAURIE R. GARCIA, ANGELICA GARCIA-RODRIGUEZ, FELICIA • GARNER, JUDY L. GHIPRIEL, HANAN GONZALEZ, CELIA GONZALEZ, SANDRA T. GONZALEZ-MARTINEZ, KARLA PATRICIA GREEN, TANIA C. GREEN-GIOCALONE, BETTY-JO GUDINO, FRANCISCO • GUILFORD, ALLYSON GUNSKI, ARLEEN JOY GUTIERREZ LOPEZ, ERIKA HA, CU HACKETT, MONIQUE HARKER, ALEXANDRIA HARMON, BRENDA J. HARPER, CORAL A. HARRIGAN, AMANDA CHRISTINE HARSTAD, EVE HARVILLE, SOPHIA L. HASHEM, OMAR AMIR HASLAM, DEBRA HAWK, JAIME • HELZER, SAMANTHA KAY HELZER, JESSICA RAY HERNANDEZ, TANYA M. HERNANDEZ-SOTO, CINDY NALELLY HERR, MICHELLE ANN HERRING, BRENDA SUE JEAR, KAREN L. JEPSON, LARAE • JOHNSON, MISTYONNA L. JOHNSTON, NATALIE JONES, LAVETTA DENISE JUCKNO, CARRIE KINCAID, ANGELA CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 • RECERT SPECIALTY AC AC C AC AC C C C AC C C AC AC A C AC C AC C AC C C C C C C AC AC C C C A AC C AC C AC C C C AC C C AC AC AC AC A C AC AC AC C HOMETOWN MORRO BAY, CA MODESTO, CA SAN MATEO, CA SARATOGA, CA SHINGLE SPRINGS, CA VENTURA, CA SAN JOSE, CA FREMONT, CA POLLOCK PINES, CA BANNING, CA SAN FRANCISCO, CA OAKDALE, CA ANTIOCH, CA LANCASTER, CA SEBASTOPOL, CA LANCASTER, CA SANTA CRUZ, CA WATSONVILLE, CA OCCIDENTAL, CA MURRIETA, CA CUPERTINO, CA COUPLAND, TX DESERT HOT SPRINGS, CA STOCKTON, CA FRESNO, CA CORNING, CA ACTON, CA POLLOCK PINES, CA FRESNO, CA SAN JOSE, CA SAN JOSE, CA LIVERMORE, CA BAKERSFIELD, CA OCEANSIDE, CA CONCORD, CA SANTA ROSA, CA PALMDALE, CA VACAVILLE, CA SAN MATEO, CA LAKE HAVASU CITY, AZ OLIVEHURST, CA OLIVEHURST, CA SANTA CLARA, CA HEMET, CA PORT HUENEME, CA RAMONA, CA SAN JOSE, CA YUCAIPA, CA SACRAMENTO, CA EL DORADO HILLS, CA PERRIS, CA FRESNO, CA REDDING, CA continued on page 8 7 C E R T I F Y I N G B O A R D U P D A T E – continued from page 7 – Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical NAME SPECIALTY KLEIN, MARY L. KNAULS, DIONNE R. KUWAMURA, MAILE ELIZABETH LAMAS, OLGA • LAW, AMY • LAWHON, JENNA LAWRENCE, BARBARA JEAN • LAYTON, PATRICIA CHRISTINE MARIE LEE, JENNIFER KAY LEWIS, KIMBERLY • LIRA, EMMA G. LIVINGSTON, KAREN • LOPEZ, CAROLLYNN ABULENCIA LOPEZ, LAURA LUNA III, TOMAS C. MACAN, NICOLE MAHONY, MARY TERESA MANZANARES, YENI MANZANO, GUADALUPE MARASIGAN, AMANDA E. MARASIGAN, MARIA ELMINA G. MARES, BERTHA A. MARISCAL, HEATHER MARTINEZ, ARIANA MARTINEZ, JOELLA C. MARTINEZ, KRISTI ANN MATHEWS, KRISTEN MC GEE, LILIAN A. McBRIDE, COURTNEY ALINA MCNALLY-KLUTH, RHONDA L. MEDINA, ANA CLARIBEL MEDRANO DIAZ, PATRICIA E. MEJIA, ELIZABETH R. MERTELL, TIFFANY N. MEYERS, ESPERANZA MILLER, DEBORAH ANN MINCHACA, COURTNIE MITCHELL, DANIELLE MONICE, LEITHA O. MONTANO, ANTHONY LEE MOORE, GRACIELA GONZALEZ MORALES, ALEXANDRA MOSCOSO-CORNEJO, ROXANA E. MULLEN, CHER • NACARELLI, CRYSTAL NALLEY, DARLENE M. NAVARRO, KRYSHA KAYE CELI NEAL, NAILA R. • NEAL, NAILA • NGUYEN, DUNG THANH NOCEDA, MARY JOAN SALVADOR OGAS, HANNAH OGLE, MELISSA E. 8 C AC AC C AC AC C C C C AC AC C C C A C AC C C AC C C C C AC C C AC AC C C C C AC C C C AC C C AC C AC AC C AC AC AC C C AC C HOMETOWN NAME LEMOORE, CA CYPRESS, CA WATSONVILLE, CA CORONA, CA LANCASTER, CA POWAY, CA SAN JOSE, CA FREMONT, CA SAN DIEGO, CA DUBLIN, CA SAN JOSE, CA SANTA ROSA, CA DALY CITY, CA SAN JOSE, CA COACHELLA, CA EUREKA, CA PETALUMA, CA SANTA ROSA, CA MANTECA, CA VALLEJO, CA SUNNYVALE, CA WHITTIER, CA PENN VALLEY, CA SAN JOSE, CA INDIO, CA MODESTO, CA PENN VALLEY, CA MANTECA, CA VENTURA, CA REDDING, CA CALIFORNIA CITY, CA LANCASTER, CA GILROY, CA ANTELOPE, CA APPLEGATE, CA GROVER BEACH, CA NEWARK, CA ATASCADERO, CA SACRAMENTO, CA VALLEJO, CA SOQUEL, CA VENTURA, CA CUDAHY, CA SAN MATEO, CA PLUMAS LAKE, CA CHICO, CA LANCASTER, CA SAN LEANDRO, CA SAN LEANDRO, CA SAN JOSE, CA OCEANSIDE, CA SAN JOSE, CA ROHNERT PARK, CA ORTEGA, MARTA MARIA OVIEDO, LORENA PAGET, CANDACE M. PALOMARES-PARRA, SUSANA PARRISH, REBECCA A. PARRY, AMANDA ANNSELLA PARSONS, BRITTANY LA RAY PAUL, MONYA D. PEDRAZA, AIRAM C. PEREZ, SERGIO PEYREFITTE, JENNIFER PHAN, MINH CHAU THI • POERTNER, RACHEL GILSON PURVIS, JENNIFER MARY PURYEAR, KATIE ANNE QUINTERO, TATIANA RABITO, JEANETTE L. RABY, VERGIE P. RAI, HARMIT K. RAMIREZ, CANDELARIA RAMIREZ, CASSANDRA RAMOS, NATIVIDAD RICHEY, REBECCA M. RIVERA, FABIAN JESUS JOSE ROCHA, MONICA L. ROCHA, CAROLINA • RODRIGUEZ, KAREN K. RODRIGUEZ, DENNISE RAQUEL RODRIGUEZ, VANESSA ROMO, SHAUNA BROOKE ROSAS Q., JOSE MARTIN ROSE, ONICA ROXAS, REBEKAH JOY M. RUBIO-PALMAS, LOLA RUIZ, ANGIE DORALEE RUNYAN, LORI J. RUSSELL, LESA RYGG, JUTTA MAYER SAAGA-PALEGA, RAROTONGA SALAS, JAIME CHRISTOPHER SALAZAR, EVELIA SAMIETZ, SHERI LYNN SAMUELS, SUSIE I. SANCHEZ, CONCEPCION G. SANCHEZ, SONIA SANCHEZ, MARIA G. SANCHEZ, ELVA SANCHEZ SANTOYO, KARLA SANDIFER, LAURA SCRIVNER, SHEENA SHAH, YAMINI • SHINGLER, TARA G. SIDDIQUI, GULNAZBANU R. • RECERT SPECIALTY C AC C C C AC C AC C C C C AC C AC A A AC C C AC C AC C C AC AC AC C C C C C AC C AC AC AC AC C AC C AC AC AC C C C C AC AC C C HOMETOWN VALLEJO, CA SANTA MARIA, CA CORONA, CA ARVIN, CA PASO ROBLES, CA SANTA ROSA, CA ANTELOPE, CA SACRAMENTO, CA WATSONVILLE, CA JACKSONVILLE, NC IMPERIAL BEACH, CA MISSION VIEJO, CA MISSION VIEJO, CA NEVADA CITY, CA RED BLUFF, CA TURLOCK, CA MORENO VALLEY, CA REDWOOD VALLEY, CA SACRAMENTO, CA SANTA CLARA, CA SUNNYVALE, CA MURRIETA, CA UKIAH, CA BAKERSFIELD, CA HEBER, CA WATSONVILLE, CA ROSEVILLE, CA SUNNYVALE, CA SILT, CO NEWCASTLE, CA LOS ANGELES, CA SANTA ROSA, CA SAN LORENZO, CA LANCASTER, CA BAKERSFIELD, CA EL DORADO HILLS, CA STOCKTON, CA CARMICHAEL, CA SAN FRANCISCO, CA BANNING, CA LAKEWOOD, CA SAN MATEO, CA PALMDALE, CA SOUTH GATE, CA LANCASTER, CA SAN JOSE, CA RAMONA, CA PALMDALE, CA CASTRO VALLEY, CA ATASCADERO, CA SAN DIEGO, CA PALMDALE, CA FAIRFIELD,CA CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 C E R T I F Y I N G B O A R D U P D A T E – continued from page 8 – Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical NAME SPECIALTY SILILAYTHONG, SANDY NONG SILVA, ELIZABETH I. SIMS, TIANNA CHRISTINE SINGH, TERESA SMITH, NICOLE BRIANNE SMITH-FIELDS, SHANNON SOONTHORN, KRYSTLE STAMATELAKY, NOELLE M. STEWART, MARY J. TAYAG, JANN CARLO TIPTON, ROBYN A. TUUPOINA, AMBER M. TYLER, LORI ALICE VALENTE-RUSSO, VIRGINIA VAN GRIEKEN, GAIL • VARA JR., ERIC JOHN VARGAS, RIANE JAURIQUE VARGAS ESCALERA, RIGO VASQUEZ, LISANNE • AC C C C C AC C C C AC AC C C AC C C AC C C CALIFORNIA HOMETOWN NAME SPECIALTY MODESTO, CA SANTA ROSA, CA VALLEJO, CA DALY CITY, CA REDDING, CA PINOLE, CA SAN DIEGO, CA SOUTH SAN FRANCISCO, CA ROSEVILLE, CA SAN DIEGO, CA ROSAMOND, CA SACRAMENTO, CA SANTA ROSA, CA SANTA ROSA, CA MANTECA, CA SAN BERNARDINO, CA LAKE FOREST, CA MADERA, CA REDLANDS, CA VAUGHN, LYNNE ELLEN VELASCO, LISA VERA-EMANI, MABEL • VUONG, ADELE WEST, SHAWNON L. WHISLER, SHARI B. WHISMAN, HEATHER WHITTED, RACHELLE WINCHESTER, SUSAN YEUNG, TSANG FUNG ZAMORA, JESSICA AC AC C AC AC AC AC AC AC C C HOMETOWN AUBURN, CA AUBURN, CA LAKE ELSINORE, CA SAN JOSE, CA GRASS VALLEY, CA PLACERVILLE, CA SAN DIEGO, CA CLOVIS, CA PARADISE, CA FREMONT, CA SANTA CRUZ, CA Congratulations to each of these medical assistants. From the California Certifying Board for Medical Assistants • RECERT MEDICAL A S S I S TA N T S A S S O C I AT I O N , INC. CMAA WAYS AND MEANS FALL CONFERENCE 2011 KNOWLED GE IS H ● EN September 8 – 11, 2011 GT C M A A STR WER PO California State University - San Marcos, CA UNITY IS We will be there with: ★ RAFFLES ★ PENS ★ MUGS ★ CMAA BAGS ★ LUGGAGE TAGS ★ BADGE HOLDERS ★ T-SHIRTS ★ SWEATSHIRTS ★ CMAA PINS _________________ Thank you for your support for CMAA! See you in San Marcos! CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 9 CONTINUING EDUCATION NCCI - What It Is and Why It Matters History In 1994, the Health Care Financing Administration, now called CMS (Centers for Medicare and Medicaid Services) awarded a contract to AdminaStar Federal, the Indiana Medicare carrier, to define correct coding practices that would serve as the basis for Medicare reimbursement. Based on their review of AMA’s Current Procedural Terminology (CPT) code descriptors, CPT coding instructions, review of existing and national coding edits and review of billing history, two main concepts were developed: • Comprehensive and component code combinations; • Mutually exclusive coding combinations that represent services or procedures that would not or could not be performed at the same time based on the CPT code description or standard medical practice. Coding combinations that fell into these two groups were distributed to physician specialty societies as well as Medicare carrier medical directors for review and comment. Based on the responses, the coding combinations were revised and a standard system, the National Correct Coding Initiative Edits, was adopted and implemented by CMS in 1996 to promote correct coding methodologies and to control improper coding. In addition to Medicare, many medical insurance carriers have adopted the NCCI Edits as standard policy when processing claims. Medicare Administrative Contractors (MAC) to process hospital outpatient claims. The other set of NCCI edits are used by Medicare carriers and MACs to process professional claims. It is important to recognize these edits apply to services performed by the same provider on the same date of service to the same patient. NCCI edits define when two procedures may not be reported together except under special circumstances and are designed to: • Prevent payments from being made due to inappropriate CPT and Healthcare Common Procedure Coding System (HCPCS) code assignments; • Eliminate unbundling of services; • Detect incorrect or inappropriate reporting of combinations of CPT and HCPCS codes; and • Curtail improper coding practices that lead to inappropriate increased payment. The NCCI editor consists of two tables of CPT and HCPCS codes containing Comprehensive/Component Edits and Mutually Exclusive Edits. Comprehensive/Component Edits In the Comprehensive/Component or Column 1/Column 2 Coding Edits, the code in Column 2 is considered an integral part of the Column 1 codes and therefore should not be reported or paid separately. The Column 1 code would be payable and the Column 2 code would be denied as bundled. Mutually Exclusive Edits The mutually exclusive table identifies procedures that cannot be reasonably performed on the same day. Many of these edits are based upon the definition of the component that differentiates one code from the other. An example would be the billing of an “initial” service and a “subsequent” service at the same time. A Word About Modifiers NCCI edits also identify some modifiers that may be appended to procedure codes to bypass edits under appropriate clinical circumstances. These modifiers, when correctly used, will bypass specified column 1/column 2 procedure code pairs and mutually exclusive code pairs. The modifiers should never be used to solely bypass NCCI edits. The medical record documentation must support the addition of a modifier to bypass an edit. How to Use the Code Pair Tables Log onto the CMS Website at www.cms.gov/NationalCorrectCodInitEd/ Select “NCCI Edits – Physicians” on the left hand sidebar. Using 99214 as the example, select the code range labeled 90000-99999. You will then have two download choices. Methodology There are two sets of NCCI edits, one set is utilized for hospital reporting and the other set for physician reporting. The first set is included in the Outpatient Code Editor (OCE) and is used by Medicare fiscal intermediaries (FIs) and 10 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 CONTINUING EDUCATION Both of the tables operate the same way. Start with Column1/Column2 and accept the terms and conditions of the AMA copyright statement. A file download box will open in a separate window, select “Open with” and then OK. The files are zipped due to their size, which allows for faster download. They can be opened in Microsoft Excel (the file ending in xlsx) or text file format. Select the Excel file for this example. To find and sort for procedure 99214, highlight column A (which is Column 1 of the Edits table), hold down the Ctrl key and hit F. When the Find box pops up, enter 99214 and select Find All. ➋ Column 1 indicates the payable code. ➋ Column 2 contains the code that is not payable with the particular column 1 code unless a modifier is permitted and submitted. ➌ The third column indicates if the edit was in existence prior to 1996. ➍ The fourth column indicates the The result below shows a portion of all Column 1/Column 2 pairs where 99214 is the payable code and every code in Column 2 is not separately payable when billed with 99214 (unless a modifier is allowed). It is important to understand the purpose of each Excel column. ➊ ➊ ➌ ➍ ➎ effective date of the edit (year, month, day). ➎ Column 5 indicates the termination date of the edit (year, month, day). ➏ ➏ The sixth column indicates if use of a modifier is permitted. This number is the modifier indicator for the edit. • Modifier indicator 0 means there are no modifiers associated with the code pair under any circumstances and the code in Column 2 will never be paid on the same day as the Column 1 code. • Indicator 1 means a modifier may be used with the Column 2 code to allow it to be unbundled and therefore considered separately for payment if it is clinically appropriate and clearly identified in the medical record as separately identifiable. • Indicator 9 means that an NCCI edit does not apply to this code pair and the edit was deleted retroactively. continued on page 12 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 11 CONTINUING EDUCATION NCCI - What It Is and Why It Matters – continued from page 9 NCCI Updates Exercise NCCI edit updates are released quarterly by CMS. The edit tables are being reviewed continually based on: Mr. Smith presents to the office with complaints of palpitations and sudden lightheadedness. He also complains of a warty lesion on his hand that catches on his clothing and sometimes bleeds. The subsequent insurance claim lists procedures: • AMA’s Current Procedural Terminology manual • CMS national and local policies and edits • Coding guidelines developed by national societies • Analysis of standard medical and surgical practice • Review of current coding practice • 99213-25 – Established patient office visit • 93000 – Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report • 17110 – Destruction of benign lesions (eg, laser surgery, electrosurgery, cryosurgery, surgical curettement) other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions The claim is processed with procedures 99213-25 and 17110 being paid and the EKG denied. The explanation of benefits states the EKG is included with other procedures performed the same day. Questions 11 – 15 on the Quiz relate to the above scenario. Using the steps in the example above, access the CMS website and the NCCI edits to determine if the EKG is eligible for separate payment. Hint: Because the EKG is the “included” code, search for 99213 and 17110 in Column 1. ❧ Why NCCI Is Important NCCI can have a high impact on claims payments and denials. It is Medicare’s expectation that the responsibility to supply the correct code on a Medicare claim lies with the practitioner or the provider. Bundled codes should never be submitted separately and cannot be billed to the patient. An understanding of the principles for the correct coding initiative will result in cleaner claims and faster payment: Read the Continuing Medical Education Article on pages 10-12 NCCI What It Is and Why It Matters then complete the Self-Assessment Test on page 14 for CME credit. • The service represents the standard of care in accomplishing the overall procedure. • The service is necessary to successfully accomplish the comprehensive procedure. Failure to perform the service may compromise the success of the procedure. • The service does not represent a separately identifiable procedure unrelated to the comprehensive procedure planned. 12 References How to Use the National Correct Coding Initiative (NCCI) Tools, Center for Medicare and Medicaid Services, ICN 901345, https://www.cms.gov/MLNProducts/downloads/How-To-Use-NCCI-Tools.pdf 2011 Spring Workshop Tour, Part B Workbook, Palmetto GBA, February 2011 J1 Medicare Advisory, June 2011, Palmetto GBA CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 HIPAA 5010? Are You Ready for TRICARE Management Activity, TriWest Healthcare Alliance (TriWest) and Wisconsin Physicians Service Insurance Corp. (WPS) are taking action to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) version 5010 transaction standards. HIPAA requires all covered entities in the health care industry to implement and use mandated standards in the electronic transmission of health care transactions, including claims, remittance, eligibility, claims status requests, their related responses, and privacy and security standards. As you prepare for the implementation of HIPAA 5010, an important step to take will be to contact your vendor, clearinghouse, billing service or payer if they supply your software. They will provide detailed information on what steps your office or facility needs to take toward a smooth transition. TriWest Provider Services Here are some readiness questions that you should ask: • Will HIPAA 5010 and ICD-10 software upgrades or changes be provided in one or multiple releases? • What will be the cost of upgrades or changes to my practice? • When will upgrades or changes be available for testing? • When can I begin testing each transaction (ex. 837 Claims, 835 Remittance Advice)? • Will I be required to test with each trading partner or payer? • What are the steps and timeframe for completing a testing cycle? • Can 4010 and 5010 transactions be processed concurrently? • How will I know my implementation has been successfully completed? • What is your contingency plan if your systems are not compliant on January 1, 2012? For more information, WPS has prepared a 5010 Readiness Schedule at http://www.wpsic.com/edi/5010-Readiness-Schedule.shtml and a 5010 Companion Guide at http://www.wpsic.com/edi/pdf/5010-TRICARECompanion.pdf. You can also refer to TriWest's EDI/ERA/EFT web page at TriWest.com/provider. “TRICARE” is a registered trademark of the TRICARE Management Activity. All rights reserved. TriWest Healthcare Alliance provides access to quality health care for 2.9 million members of America’s military family in the 21-state TRICARE West Region. CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 13 CONTINUING EDUCATION NCCI - What It Is and Why It Matters – Self-Assessment Test SELF-ASSESSMENT TEST AVAILABLE FOR DOWNLOAD SEPARATELY. 14 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2011 CONTINUING EDUCATION CONTINUING EDUCATION CREDIT ARTICLES Please indicate the articles you wish to order. One credit articles are $5 each or five articles for $20. Three credit articles are $15 each. 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