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Hi William,

I'm sorry you are having trouble but THANK GOD it's not just me!!! I got a 67 on that exam!!!!   I missed 10 questions!! Up to now, I have only missed 1 question on the exams.  I had 2 big problems:  1.  On the Reading about Neoplasms at the beginning of this section, it said "do not attempt to provide morphology codes, that the test questions do not give you the morphologic description so you cannot select anything other than a generic morph code".   2.  My biggest confusion....If they don't exactly say Primary Malignancy, how do you know that's what it is???? I just kept putting unspecified. AHHHHHHHH   Spent the last 2 days being very upset about it all. Tonight I need to send a very long email asking for explanations of all of them because I don't understand what I did wrong.   I re-read the MT Stars link Linda gave a while ago from "Coder" and that helped me feel a little better.  I am really stuck on what they mean by morphology.  Is it when they say adenoma, sarcoma?    I hope it's okay putting this on here, I typed some tests questions then deleted them because I know we aren't supposed to ask about tests, I tried to stay general.  Ughhhhhhh....just want to get past this chapter. 

A reminder to all students - you can and should ask questions during exams if you have them!  Never never NEVER guess!

Whew, now that I have that little rant off my chest... :)

Some students received versions of the code book that include morphology codes, which are a different type of code from the regular ICD codes you are learning in our course.  If you're curious, check out this wikipedia entry on them:

https://en.wikipedia.org/wiki/International_Classification_of_Diseases_for_Oncology

The short explanation for beginning coding students is that if you're trying to assign a code that starts with "M" (and doesn't include a period in it) on your Neoplasms questions, you're looking at a morphology code by mistake.  Correct Neoplasms codes will start with a "C" or "D" instead.

Unless it is specified otherwise, if a neoplasm is listed as malignant, it will be a primary malignancy.  If it's secondary or in situ, it will be specified as such.   You would only use "unspecified" if they give you nothing at all to work with, such as just "lung neoplasm."  Even then, it wouldn't hurt to email your instructor before you submit your test to make sure there's no additional information available for that question!

-Glenda

Yes, NEOPLASMS, AKA Meltdown territory.  

You can do this. You WILL do this.  Just follow Glenda's instructions above and keep taking it one step at a time.

I am OK now.  The moral of the story is when you're unsure ask.  Glenda emailed me and said that some questions were on the test to simulate the real world where if you didn't have enough information you had to ask.  We are after all now on section 14 if you're doing neplasms, so I guess we can start looking forward to more real world simulation from now on.  Personally, that's fine with me, and all the better.  I just got moving at a break neck pace there and took it for granted that things would always be so quick and easy. 

Funny though, God (or fate if you want to call it that) knows how to help you out when you're really at your limit.  The test flop was the latest in a series of mini-traumas.   I was notified today I won an $800 sewing machine from a contest I entered with the local Janome sewing machine dealer.  It's on my desk right now.  I haven't gotten the chance to even try it out.  It, and its 163 stitches plus alphabet and numbers, are all mine to do with as I please except sell it during the warranty period of two years.  I think that has something to do with competing with the dealer.  I also had to agree to allow them to use my picture and name in the sales flyer.  I really needed that boost.  It was just what I needed too, as I had been coveting a new sewing machine since before I lost my job and was saving for one.  I never dreamed I would get this high end of the line though.

ONWARD!!

William,

Congratulations on the sewing machine.  I have always envied people who have talent for sewing and crafts.  That gene went from my mother to sister and skipped me entirely, though I am world famous for my ability to thread a needle for my visually impaired mother. 

Diana

I'm just curious since I'm not to Neoplasms yet.  How did you guys do on your quiz for that section?  I'm hoping to catch these difficult coding scenarios on my quizzes :)  Thanks!

Cyndi

Oh my goodness!  I actually did very well on that section, but it was definitely the most challenging for me so far.  I ended up missing 1 on the section exam.  I actually did send an email with questions to my instructor, but I ended up finishing that section prior to receiving my email response from the instructor.  I researched high and low and utilized ICD10 Data website to check and double-check my answers.  I kept doing it until I figured out how they came up with their answer.  Luckily, I love a good challenge but I felt great when I got 97%.

I did good on the quiz, but failed the exam.  I should have asked questions, I just wanted to get it over with. 

Not sure what you mean on quiz vs. exam.  If you mean the exercises, I did wonderful on those.  The problem was the exam.  I did miss one that dealt with psychiatry also.

I promise you that coding neoplasms does get easier with practice!  I can tell you that when I am coding neoplasms at work, I prefer to use the table in the book over the Encoder.  The book is much easier for me to navigate through, but that's just my personal opinion.  You will do fine with some more practice.

Kristi

What is an encoder?

Yes, I'm curious...what is an encoder?

An encoder is software that lets you code your cases without code books.  It provides a way to look up the codes and add the codes to your case's code list.  It might also check for certain kinds of errors, like using a pediatric immunization code for an adult or coding a prostate condition on a female, or it might also check Medicare and insurer policies to be sure that the diagnoses meet medical necessity for the procedures you coded.

There are two basic types of encoders.  One acts like an online code book.  It lets you search for what you need, then shows you the same kind of text that you see in the alphabetic index.  When you choose something there, it takes you the tabular list and shows you what you would see in your book.  You can click on your choice to add it to your list of codes.

The other is a decision-tree sort of software.  3M is the most popular of that type.  With that, it asks you questions to whittle down the choices until you eventually come to a code.  It also can check for errors, etc.

The hitch with encoders is that if you can't code effectively with a code book, you run the risk of selecting something nuts from the encoder.  It can be difficult to see what you're doing in the encoder, so you can get way off track.  However, with both types you can still just type in a code number if  you know it. 

Don't be concerned about encoders being scary or difficult to use.  They're just software and they're usually easy to pick up on with even minimal training.