Coding Tips
Source: MGMA Interview with Margie Vaught, CPC, 6/19/2009
Three coding tips regardless of specialty:
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It really needs to be a team effort.
The provider needs to be able to have access to the coder/biller, and the coder/biller needs to have access to the provider. There needs to be some kind of communication, whether it's via e-mail or a form, there has to be that connection. And many offices with outsourcing their billing or their transcription, they lose that continuity because of the fact that there isn't that connection. I really feel for offices that don't have that open rapport.
Whether coder/billers go to the administrator/practice executive and say, "Here are concerns, could you bring them up at the next board meeting?" or the coder/billers are invited to the next meeting to discuss it - teamwork is one of the biggest keys to getting everyone on the same page.
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Route the explanation of benefits (EOBs) to the people who are checking the coding and the billing, so they see what's going on.
Usually what happens is, the coders and billers are in one section, they put in all their things and the bill goes off. And then the check comes with the explanation of benefits. The check goes to the controller, the EOB goes off to another department so they can key in the information on the patient's encounter. So if there are errors or problems, it doesn't ever get back to that coder or biller.
As a coder, how am I to know if I forgot a modifier? Maybe I transposed codes? There has to be - whether you do it weekly, monthly, bimonthly - a sit down to go through those EOBs. The bigger the practice, the harder it is for the coders and billers to know if their coding is going through or if they're getting denied. As an executive administrator, you have to keep an eye out if you need more training for your staff, of if you need to replace staff because they're constantly making errors.
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Make sure you're keeping staff educated.
Just like physicians are required to have so many continuing education units for their degree or for their state license, the same thing applies to your coding staff. In fact, the OIG Compliance Program clearly documents that there needs to be continued education. They leave the education up to the actual practice, but you need to show if (for any reason) you get pulled into an audit that you were trying your best and training your people.
Even if you have a low budget, there are Webinars and subscriptions to different magazines that give official sources [of coding information]. It's up to the provider to make sure that information is getting to the coders.