Health Information Management

Three tips for conducting coding audits

HIM-HIPAA Insider, January 25, 2011

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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.


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