M edical coding is far more than just filling in the blanks on a claim form and assigning numbers to services, procedures, supplies, and diagnoses. Medical codes are but one piece in the enormous mosaic of documentation that payors, litigators, and government officials use to track and pay for our nation's healthcare delivery and to measure its outcomes.

Coding serves as a communication vehicle to insurers, making it known who was treated, why, what was done, how much was billed, and where and by whom the services were provided. When claims are completed properly, coding enhances and acc

T heresa ("Terri") Maxwell, RN, MSN, FNP, CWOCN, has always worked two or three jobs at once. Not long after earning her BSN from Research College of Nursing/Rockhurst College, Kansas City, Mo., Terri worked simultaneously as a staff/ICU nurse and surgical unit nurse and served as a clinical instructor for the RN program at her hospital in St. Joseph, Mo. She has been a nurse in a surgeon's office, a motivational instructor for high school students pursuing careers in health occupations, and a home health clinician. With her initial dream of starting her own business realized, she is now looki

T he incidence of chronic wounds, including pressure ulcers, diabetic ulcers, venous ulcers, and arterial ulcers, is increasing as our population ages. The prevalence of pressure ulcers has been reported to be as high as 11% in the hospitalized population and 20% in the nursing home population.¹ The cost associated with the treatment of these wounds is staggering and estimated to exceed $7 billion per year.² Chronic wounds are painful and may lead to a number of complications, including: disability, need for assisted living or home care, depression, loss of digit or limb,

I n the realm of wound care, healing may stagnate despite the healthcare provider's best efforts. The behavioral tendencies or attitudes of the patient may contribute to the chronic nature of wound healing. Perhaps the patient has disassociated from the wound - showing up for the appointment is enough, and the healing part is up to the healthcare provider. In another scenario, the patient may feel powerless to make the recommended changes: The sheer pain and stress of having a wound does not allow the patient to make a behavioral change such as smoking cessation. Another subset of patients see