# Grider book inconsistencies?



## Captain74

Hi-

I have been studying for the CPMA exam using Deborah Grider's Medical Record Auditor 3rd Edition and I seem to be finding some inconsistencies from what one definition is to actual examples.  Did anyone else find anything like that?

For example:  In Auditing the Office Medical Record (Chapter 7 in this book), the HPI - Modifying Factors is defined as actions taken to make the problem, symptom or pain better or worse (pain relievers, etc).  In Case #2 in the same chapter the answer implies that the patient "has had some laryngitis" as a modifying factor, when I would consider that an associated sign or symptom.  The patient's complaint is Dry Frustrating Cough.

Am I just crazy?  Anyone experience anything like this in their copies?

The answers also say the patient has had no surgeries, but the note indicates patient has had a deviated septum repair.

I am finding it very hard to study for the CPMA exam when I can't even agree with the text that suggested for studying.  If I could see the logic it might help, but in these 2 examples I just don't see how I can agree with that.

Any suggestions/thoughts?


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## btadlock1

Captain74 said:


> Hi-
> 
> I have been studying for the CPMA exam using Deborah Grider's Medical Record Auditor 3rd Edition and I seem to be finding some inconsistencies from what one definition is to actual examples.  Did anyone else find anything like that?
> 
> For example:  In Auditing the Office Medical Record (Chapter 7 in this book), the HPI - Modifying Factors is defined as actions taken to make the problem, symptom or pain better or worse (pain relievers, etc).  In Case #2 in the same chapter the answer implies that the patient "has had some laryngitis" as a modifying factor, when I would consider that an associated sign or symptom.  The patient's complaint is Dry Frustrating Cough.
> 
> Am I just crazy?  Anyone experience anything like this in their copies?
> 
> The answers also say the patient has had no surgeries, but the note indicates patient has had a deviated septum repair.
> 
> I am finding it very hard to study for the CPMA exam when I can't even agree with the text that suggested for studying.  If I could see the logic it might help, but in these 2 examples I just don't see how I can agree with that.
> 
> Any suggestions/thoughts?



You're not crazy. I had the same issue with the second edition, and it nearly drove me insane - I couldn't tell if I was genuinely not learning something, or if I'd just come across another mistake in the book, when I missed things. 

And _good luck_ getting any answers on it - Deborah didn't take my critiques well, when I finally asked the AAPC about it, in utter frustration. You're better off supplementing it by reading the publications on this page: http://www.trailblazerhealth.com/Sp...uation and Management/default.aspx?DomainID=1

Trailblazer's good, because they're notoriously picky with their E/M requirements, and they explain it in easy-to-understand ways. Also, you can check yourself by asking about questions on here - we're always glad to help! 

If it's any consolation, I passed the first time I took it, with no actual auditing experience - the curriculum works - it just desperately needs to be edited. So, if you find yourself getting confused, take comfort in the fact that it may just be the book.


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## Captain74

Thanks Brandi.  I have been auditing records for a few years now and just feel it is about time to get the certification, but after using this text I feel like I have been really missing something all this time that seems so logical.
I think I am going to finish up the book, take the practice test and see how I did.  Then register for the test since I can't afford the class that is being offered.

I'll be looking you up for help later.


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## btadlock1

Captain74 said:


> Thanks Brandi.  I have been auditing records for a few years now and just feel it is about time to get the certification, but after using this text I feel like I have been really missing something all this time that seems so logical.
> I think I am going to finish up the book, take the practice test and see how I did.  Then register for the test since I can't afford the class that is being offered.
> 
> I'll be looking you up for help later.



There wasn't a practice test when I took it - there's one online, now? That should help, if so, since they actually edit those.

If it's just in the book, just a heads-up: that probably wasn't reviewed, either...
I totally understand your situation - I was in the exact same boat; I couldn't afford the plane ticket to reach a class, much less the tuition, and I had no one around to ask for help. 

Back then, I hadn't started using the forums, so I had* no idea *that I was missing out on free tutoring - it would have been nice to at least know for sure, whether or not I was on the right track. But, oh well...I still learned it, and now I can share what I know with those who need it. 

Good luck!


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## ollielooya

THANK you both for sharing this information.  Nothing is more frustrating and BP elevating than to be second guessing from material that may have slipped thru the editing process.  Surely, you can look back on it as a learning process, but oh the aggravation of it all!  C'mon, learning this stuff is difficult enough already!!!  Thanks for the heads up...
---Suzanne E. Byrum CPC


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## losborn

*Not Crazy!!*

I too found the Greider book to be next to useless.  I had called AAPC for a recommendation on a study guide. They assured me the Greider Manual was an excellemt source book.  (They also actually recommended studying @ 1500 pages of publically available documentation, including the Federal Register and the entire Medicare billing manual!)
So I ordered the second edition (only available at that time) only to discover that the third edition was out about two months later!  I really felt AAPC should have informed me that a new edition was imminently available.
I am sorry to hear the third edition suffers from the same problems as the second.  It got me so riled up I nearly wrote to the AMA that they should be more careful about with whom they partner!  Not only are things wrong and confusiong, she liftes entire paragraphs from one section, plops it into a different section, and changes a few words so that it is not identical.  I figure when you pay for 400 pages of information, there should be 400 pages of information, and not be so repetitive.

I did find the CPMA manual put out by NAMAS to be excellent, however.  If you study that, you don't neet to take the class.

Best of luck!

Lin


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## dclark7

I had Grider's 1st edition which I didn't find all that helpful.  I also didn't find the NAMAS manual that great.  I found the most helpful information was the CMS Evaulation and Management Services Guide http://www.cms.gov/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf and the OIG website.  The OIG website has physican training and podcasts http://www.oig.hhs.gov/compliance/physician-education/index.asp, http://www.oig.hhs.gov/newsroom/video/2011/heat_modules.asp.  Also as Brandi said the forum is extremely helpful and I found the online practice test was a good tool.  good luck on your exam


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## btadlock1

losborn said:


> I too found the Greider book to be next to useless.  I had called AAPC for a recommendation on a study guide. They assured me the Greider Manual was an excellemt source book.  (They also actually recommended studying @ 1500 pages of publically available documentation, including the Federal Register and the entire Medicare billing manual!)
> So I ordered the second edition (only available at that time) only to discover that the third edition was out about two months later!  I really felt AAPC should have informed me that a new edition was imminently available.
> I am sorry to hear the third edition suffers from the same problems as the second.  It got me so riled up I nearly wrote to the AMA that they should be more careful about with whom they partner!  Not only are things wrong and confusiong, she liftes entire paragraphs from one section, plops it into a different section, and changes a few words so that it is not identical.  I figure when you pay for 400 pages of information, there should be 400 pages of information, and not be so repetitive.
> 
> I did find the CPMA manual put out by NAMAS to be excellent, however.  If you study that, you don't neet to take the class.
> 
> Best of luck!
> 
> Lin



Ha! That happened to me too! I was *so* mad to see the third edition out, literally a couple of weeks after receiving my second edition, which was the 'recommended' study guide, when I ordered it. I also thought that they should have had a 'coming soon' note somewhere, but I guess it would have hurt sales on the 2nd edition. 

I *did* write the AAPC about it, and they forwarded my note to Deborah. I posted the exchange in an older thread about this (here: https://www.aapc.com/memberarea/forums/showthread.php?t=51850&highlight=grider)

It diminishes the integrity of their study material, when errors like that are ignored. If you claim to have a high-quality product, you should ensure that you actually do. Just sayin'.


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## losborn

I couldn't agree more.

Seems to me you shouldn't treat your membership that way!

Well - I passed as well.  Has I failed, I may have written the AMA!

Lin

CPC  CMPA CEMC


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## Captain74

*Thanks*

Thanks for all the resources and support.  I checked the NAMAS website for their materials and they are currently on back order.  I contacted them to get a timeframe and I haven't heard back.  I am guessing that now that AAPC and NAMAS are doing this certification together, the NAMAS materials will be the recommendation.

Oh, and didn't Deborah Grider leave AAPC?  Maybe now there wouldn't be such strong support for materials created by her.

Either way, I am going to get the NAMAS book, study and take the test.  I will likely be posting any questions I have so keep your eyes open.

Thanks again,


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## RebeccaWoodward*

*Way to go!*

Wow Brandi!  I don't know how I missed the thread you referenced aboved but KUDOS to you!  What a powerful, professional response. You are a true example of excellence!


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## dballard2004

I have the second edition of this book and I have never purchased the third edition, but it does make one wonder if the same errors exisit in the new edition.

Not to reflect off of the subject here, but did Deb Grider leave the AAPC?  I don't remember any communication from AAPC that she had left.  I have noticed that she is not included in the Coding Edge anymore and wondered if she was still with them.


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## btadlock1

*Lol!*



RebeccaWoodward* said:


> Wow Brandi!  I don't know how I missed the thread you referenced aboved but KUDOS to you!  What a powerful, professional response. You are a true example of excellence!



Awww, shucks! Thank you!


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## btadlock1

dballard2004 said:


> I have the second edition of this book and I have never purchased the third edition, but it does make one wonder if the same errors exisit in the new edition.
> 
> Not to reflect off of the subject here, but did Deb Grider leave the AAPC?  I don't remember any communication from AAPC that she had left.  I have noticed that she is not included in the Coding Edge anymore and wondered if she was still with them.



I've been curious about that too...one day she's CEO, then all of the sudden, it's Reed Pew, and she's vanished! Who knows?


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## btadlock1

*Oh...there she is!*

Looks like she's @ Blue and Company, according to LinkedIn: http://www.linkedin.com/pub/deborah-grider-cpc-cpc-h-cpma-ccs-p/14/14a/64a


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## twizzle

*NAMAS guide*



Captain74 said:


> Thanks for all the resources and support.  I checked the NAMAS website for their materials and they are currently on back order.  I contacted them to get a timeframe and I haven't heard back.  I am guessing that now that AAPC and NAMAS are doing this certification together, the NAMAS materials will be the recommendation.
> 
> Oh, and didn't Deborah Grider leave AAPC?  Maybe now there wouldn't be such strong support for materials created by her.
> 
> Either way, I am going to get the NAMAS book, study and take the test.  I will likely be posting any questions I have so keep your eyes open.
> 
> Thanks again,


This guide is not without its faults/inaccuracies.
In the section where they talk about specialty physical exams, in the 'male GU' section they mention menstrual history. Who edits these things?


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## Julie Davis

My staff and I all reviewed the Grider book (third edition) as well as the NAMAS book.  I found them both to be helpful, but as always when you run across something that seems blatantly wrong, go with your own common sense.  You are most likely right!!


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