by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA
Coding is important. It is how we track and quantify the health of individuals and our nation’s population as a whole. It is used to measure and improve the quality of the services our healthcare organizations provide. It becomes the data in the shared repository of health information to support research and advancements in medical science. Coding is essential to our efforts to improve the quality of health data and through that the quality of care and overall health of our country.
It is also how healthcare organizations get paid. And because there is money involved, there is a team on the other side working just as hard to decrease, delay, or deny any reimbursement for the services your organization provides.
As a person with oversight to the coding process it is time to think strategically.
- Your coders are professionals paid for their knowledge and skill. It is simply unacceptable for them to not know what changed, what it means, and how to apply it. The smallest change to a code or guideline is still a change that can result in a denied claim.
- Put up a fight. Review your denials and challenge any you can. Do not assume payer audit findings are correct. Payers have every incentive to find ways not to pay you and you need to push back. Prove them wrong.
- Be a tough audit. If your coders are up-to-date and well-trained and their coding is accurate, by-the-book, complete and defensible, there will be fewer findings. Auditors will move on to more ‘productive’ targets.
- Take advantage of your opponent’s weaknesses. Payers also struggle to keep up with changes and keep their staff fully trained.
So how do you do this?
I believe the answer lies in providing the training resources necessary to support your coders. There is a qualitative difference in how coding education is provided and you will see the results in your team. Getting it right and doing it quickly is your goal. You need both. An investment in comprehensive and in-depth training will pay dividends in both coding quality and productivity.
A word about updates
Coding quality is always important but the yearly code changes have a way of focusing the mind. It is up to you to set the bar high for your coders. Communicate to your team your expectation that they will master the code changes and be prepared to implement them on discharge date one.
This is not about ‘one-and-done,’ ‘check the box’, ‘someone tell me what to do’ training. This is about giving your coders the time and tools necessary to truly prepare. It is too important to your organization’s financial health to not step up to the challenge.
FY 2022 Code Updates: ICD-10-CM, ICD-10-PCS, and CPT
FY 2022 Code Updates: Learn what the changes mean and how to apply them. Purchase individually or pick your bundle and SAVE! Train your entire team and save even more!
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Bonus! Receive a full year of Coding Clinic Commentary, a $100 value FREE with your purchase of two or more Code Updates.