Health Information Management

Three tips for conducting coding audits

HIM-HIPAA Insider, January 25, 2011

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

With an ever-growing list of RAC-targeted MS-DRGs and a host of coding compliance traps that continue to haunt coders, conducting internal audits is no easy task. Keep these general auditing tips in mind to help ensure you’re auditing effectively: 

  • Seek outside help. Ask someone outside the coding department (e.g., a compliance professional with coding credentials) to conduct the audit. This helps maintain objectivity and brings a fresh perspective to the audit, says Julie Daube, BS, RHIT, CCS, CCS-P, manager of coding quality review and education at Care Communications, Inc., in Chicago. For example, this individual may be able to point out an incorrect application or interpretation of a coding guideline that all of the coders are inadvertently using.
  • Hire an external auditor to conduct an audit at least annually. These individuals are objective. They also can offer numerous compliance solutions based on their knowledge gleaned from working with hospitals nationwide, says Daube.
  • Conduct coder-specific audits for both internal and external (contracted) coders. These audits can reveal the need for targeted education, and they can help coding managers capitalize on coders’ skills to enhance compliance, says Daube. “It’s always good to know the strengths and weaknesses of your coders so you can assign them the work related to their expertise. That in and of itself will help coding accuracy,” she says.
Editor’s note: For more tips, see the January issue of Briefings on Coding Compliance Strategies.

 



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    The HIM Director's Guide to ICD-10
  • The HIM Director's Guide to ICD-10

    ICD-10 is the biggest change for the HIM industry since the implementation of DRGs in the 1980s. HIM directors must take...

  • ICD-10 Trainer

    ICD-10 Trainer provides the latest news and updates related to ICD-10 regulations, and tips from HCPro experts and faculty...

  • Mastering the Three-Day Payment Window

    During this 90 minute audio conference our expert speaker, Kimberly Anderwood Hoy provides a brief history of the rule...

  • Prevent Denials and Win Appeals:

    Hospital case managers and directors of case management will find Prevent Denials and Win Appeals to be a valuable partner...

  • Acute and Chronic Renal Failure Coding:

    Our experts address new AKIN criteria, acute vs. chronic kidney disease, and other clinical aspects of renal failure and...

Most Popular