In the world of medical billing and coding, accuracy is everything. The changes that are currently taking place and set to take place in the healthcare industry are massive overhauls of the previous system and thus, producing a high level of accuracy will be more difficult than ever. Starting October 1, 2015 all healthcare providers who follow HIPAA guidelines will be required to use the new ICD-10 diagnostic code set instead of the currently used ICD-9 code set, and with this change 55,000 new diagnostic codes will be created along with a slew of other changes. It is safe to say that there will be enormous amounts of pressure heaped on billers and coders to keep up with and understand these major changes.
5 Tips Every Coder Should Know
Medical billing and coding is extremely important for 2 main reasons. The first is that coding is used to diagnose and keep track of major disease trends. The second reason why it is so important is that the work medical billers and coders do is directly related to the amount of revenues a healthcare facility brings in. If a facility’s billers and coders are unable to adapt, understand, and effectively use the new code set, these facilities stand to take great losses in revenues as the CMS (Centers for Medicare & Medicaid Services) are tightening the requirements for revenue disbursement. In order to help maintain high efficiency and accuracy in coding, here are 5 tips that every biller and coder should take note of.
- When new patients are seen at your facility it is important to investigate their previous medical records. Try to determine if these patients already have specific HCC codes assigned by their previous healthcare providers. Reviewing a patient’s medical history will allow these patients to receive the continuous care that they need and will also give you a starting point for future coding with the patient.
- Every single year, it is important to monitor each patient’s assigned HCC codes. In HCC coding, you want to see consistency and if there are certain patients with decreasing numbers of HCC codes assigned to them, it is important to examine these patient’s treatments and coding extra carefully. A patient with a large drop off in the number of HCC codes assigned to them could be receiving inadequate care or could possibly be having their treatments poorly documented. It is the job of coders to ensure that patient care is coded properly, but without excellent documentation this can be a nearly impossible feat.
- Almost all facilities nowadays send their coding data to their health plans electronically. If your facility sends the data electronically, it is likely that you utilize the services of and EDI (electronic data interchange) provider. It is important to work closely with your EDI provider and make sure that they send you rejection reports. These reports will allow you to see where you are missing out on money and why. It is also important to find out all codes that the EDI vendor sends to the health plans as you may discover new or forgotten codes that can possibly be used to help boost revenues.
- In October of every year, new HCC diagnosis codes are added and older, less relevant codes are deleted from the code set. If you are not regularly monitoring these code changes you will surely miss out on potential revenues. Educate yourself with the most recent and up-to-date codebooks so that you can be sure you are not missing out on any coding updates.
- Regularly reviewing patient charts is a great way to stay sharp while also looking out for documentation errors and weaknesses. If you are finding repetitive errors in the documentation, you should consider developing guidelines and additional training programs for physicians and staff members at your facility so that you can ensure maximum revenues for the facility.
Unsure About Your Coding Efforts?
The fact is, HCC coding is very difficult and stressful work and it is only getting worse with all of the new healthcare laws and rules that are going into effect. Healthcare facilities need to be sure that they are employing the best billers and coders around because if they are not, the potential problems could be devastating to the well being of the facility and its patients. If you want to increase the effectiveness of your coding efforts, utilize the skills and expertise of the professional coders at HCCCoders.com. We provide our customers with the most skilled and well trained coders in the industry and we stand by the results that they will bring to your facility. Don’t wait any longer and start working with real coding professionals today.