Learn How to Minimize Errors and Maximize Outcomes in Coding

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Coding Accuracy is a term related to the healthcare systems where accurate coding is critical to the appropriate treatment of patients, clinical research, and reimbursements. It is not only vital to clinical and financial decision making in the healthcare sector but also to study and compare trends worldwide. Auditing the codes and making sure that the data is relevant and clinically validated are essential steps to help take the quality and reach of healthcare facilities to the next level.

What does Coding Accuracy mean in the Healthcare System?

Vijay Prasad, a college homework help expert to IT students, explains, “The coding accuracy is done at two levels. Coding auditors need to take a random sample of 2% of patients of every type and review their records for:

  • Diagnostic Related Group or DRG accuracy, and
  • Overall coding accuracy.

DRG accuracy is about how accurate the diagnostic and procedure codes are, while overall coding accuracy evaluates other elements related to programming. DRG accuracy should be at least 95% while overall coding accuracy should be at least 90%.”

How to Improve Coding Accuracy?

Accurate coding is not a prerogative of large teams. Even if you are working solo or have a slim staff working on a shoe-string budget, you can still do a few things to improve the revenue cycle performance of your organization. Here are a few easy and actionable tips to improve medical coding accuracy:

1. Concentration is the key to increase accuracy in Coding

Jack Alcatraz, a programming assignment help writer with GoAssignmentHelp, says, “Once interrupted, a coder takes 23 minutes on an average to be able to reach that deep level of concentration again. Hence, blocking time for projects and minimizing distractions during that period is crucial to increase his or her productivity.”

Some of the ways Jack suggests to minimize such distractions are:

    • Coders’ should be seated far from staff refrigerator, break room, water cooler, smokers’ area or any other area with heavy foot traffic and loud noise.
    • Turning off email and other notifications during the project time is highly recommended.
    • Do away with unnecessary meetings that eat into coders’ time.
    • Limit the non-coding tasks coders do. Sometimes, organizations assign coders to do front-end duties like scheduling appointments or help patients check-in. Such tasks cause constant disturbance and do not allow a coder to concentrate on the code they are working on. If it is necessary, coders may have separate timings for coding and non-coding tasks.

2. Learn how Healthcare Works and what changes are taking place

One main problem with coders is that they do not understand the working procedure in the healthcare system well. Abha Wadia, a Nursing assignment help expert, says, “Somebody who is going to create a software or program for the healthcare professionals need to have an understanding of how EMR operates. They need to understand different roles professionals play in the Emergency Room – right from the front desk to revenue cycle specialists to clinical support to administering treatments. This will give them a clear idea of how to process information and make work easier for the end-users of the program.”

As a coder, you should also be updated about the latest set of:

  • CPT (Current Procedural Terminology) codes used by physicians, hospitals, laboratories, and other stakeholders to describe the services and procedures they perform,
  • HCPCS (Health Common Procedure Coding System) which is a standardized terminology to identify products, supplies, and services not included in the CPT, such as durable medical equipment, prosthetics, ambulance services, and other medical supplies, and
  • ICD (International Classification for Diseases) which is the terminology healthcare providers and insurance companies check for in patients’ records to understand their diagnoses, symptoms and procedures and assess the claims they make.

These codes get updated annually and have a major impact on value-based patient care. For example, ever since Medicare Advantage Plans take RAF (Risk Adjustment Factor) into account for reimbursements, HCC (Hierarchical Condition Categories) model has gained a greater significance in medical coding.

Being up-to-date is crucial for a coder working for the healthcare industry.

3. Do not shy away from Coding Audits

Programming assignment editing expert, Amber Batista, says, “Regularly-scheduled coding audits are necessary to identify quality issues and address them in time. It has to be a healthy, positive experience for the coders directed towards continuous professional growth of coders and getting better outcomes.”

The auditors should preferable by third-party impartial coding experts. They look at the codes and make recommendations on how compliant the codes are and how they can be improved. It is also important to document everything because it highlights your commitment to maintaining the coding accuracy over revenue generation. The documentation should provide clear instructions and guidelines to coders on what to do and what not to do in the future.

If you are working on a budget, auditing can be a costly exercise. In such cases, you can pick 5-10 major cases randomly and get them audited. 

4. Choose your resources wisely

Matthew Kraft, a Law assignment helper, warns, “If you are choosing to hire remote medical coders to increase the cost-effectiveness of your EMR operations, you must sign a Business Associate Agreement (BAA) with them approved by your legal department and compliant with the HIPAA (Health Insurance Portability and Accountability Act).”

Some of the great coding resources are:

  • AMA (American Medical Association) offers new and latest coding resources that you may use. 
  • NCCI (National Correct Coding Initiative) edits offered by the CMS (Centers for Medicare & Medicaid Services) allow you to see if your coding selection is payable on the same date of service or not. 
  • CMS Physician Fee Schedule Search Tool can help you find the right doctor, surgeon or medical assistant.

Several other tools and calculators are available online. As a coder, you must choose them with caution. Validated and verified resources are conservative but they allow you to keep misinformation at bay.

5. Credentials are good, the experience is invaluable

Coding credentials and certifications show that a person has studied the subject and passed the course. But the experience in the field matters too. So, when you are looking for advice, choose someone who has years of experience in the field and a good track record to back it up.

Joining the coding forums can help you network with other coders working on similar projects and find quick solutions to your problems.

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