Health Information Management

Pay-Per-View: Improve coding quality and reimbursement

APCs Insider, May 21, 2010

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Coders know that, with few exceptions, they may not report something that a physician has not documented. Queries are necessary to obtain clarity and specificity. They take time and delay processing of the record, thereby increasing the unbilled balance on the discharged-not-final-billed list. Coders often know which physicians will respond to queries and which will not. And if coders query for specificity on every possible account, physicians may have more queries to which they must respond than records they must complete.

Queries aren’t as effective as face-to-face discussions with physicians. Coding managers must assess queries being formulated, the reasons behind them, and the physicians to whom they are directed. Coding managers then should arrange to meet with individual physicians privately to review coding nuances or rules of which they may be unaware. Providing physicians direct face-to-face time and focused education will yield much better results than written queries that don’t explain what is lacking in the documentation.

Continue reading “Improve coding quality and reimbursement” on the HCPro website. Briefings on APCs subscribers have free access to this article in the May issue.

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