Health Information Management

Coder vs. biller: Does this match have a referee?

Briefings on APCs, July 1, 2008

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The subject can come up at any gathering of HIM professionals: the friction that can arise between billing and coding departments. Conversation about these conflicts has even reached the blogosphere. A thread on Advance’s HEALTHCARE POV blog began with this classic example:

I presently work in an acute hospital setting as an ED coder. Our billing department is constantly reviewing our dx codes (especially for Medicare/Medicaid) accounts, and they are always asking us to look for additional codes to add so that we can get payment. In fact, one biller in particular actually gets into our accounts and adds codes so that payment can be made.

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