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Training:

'V' Is For Very Confusing

Published on Sun Jan 25, 2004

These tips can turn that V into "victory."

If you're looking for the key to V code accuracy, think education.

In the three months since V codes became required as part of accurate diagnosis coding in home health, coding confusion has multiplied. Changing to V codes and using them properly was bound to be a huge headache, says Rachel Hammon with the Texas Association for Home Care. Home health coders still hadn't mastered coding guidelines as it was, and this just added one more thing to think about.

"It's not something you can pick up by reading CMS' memos," warns consultant Pat Sevast with American Express Tax and Business Services in Timonium, MD. People are easing into it and may overuse V codes at first, she says.

And V codes don't change many coding basics, cautions Cushing, OK-based coding consultant Laresa Boyle. Clinicians still need to focus on why they are in the home and document thoroughly, she advises.

CAUTION: One difficulty with V codes is that they are not optional, but a V code is not required in every case, Sevast explains. Also, agencies are supposed to follow professional coding standards, but most people in home health aren't familiar with these standards, she says. And professional coders often don't understand home care, she adds.

"To really gain solid understanding of how to use V codes, some type of formal education is necessary," emphasizes Sue Bowman with the American Health Information Management Association in Chicago.

The V code examples the Centers for Medicare & Medicaid Services provides cover some commonly seen situations, but they are just a beginning, experts tell Eli. "Not everyone can afford a professional coder, but send at least one person for training," Sevast urges.

More ideas: Experts suggest other ways agencies can learn more about V codes:

  • Hire a coding consultant to come to your agency and provide face-to-face instruction.

  • Send agency staff members to a class or a conference.

  • Participate in as many audioconferences and training sessions as possible, so you can hear the information over and over and ask questions.

  • Follow up with monitoring to be sure the staff understood the training provided.

  • Use online training tools such as AHIMA's home health coding program. This program covers much more than V codes, Bowman explains. But it's an excellent resource for those responsible for ICD-9-CM coding in the home health setting, she reports.

    Editor's Note: AHIMA's course is at http://campus.ahima.org/campus/course_info/HH/HH_info.html.

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