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Completing a coding audit can aid revenue management

November 3, 2010

One of the most essential keys to smooth practice management is accurate medical coding. If a practice codes correctly, it may avoid external audits from payers and help ensure its staff is getting paid for the work they do.

The best way to determine whether your coding is correct is to complete a coding audit.

The American College of Physicians compiled some rules to help physicians with an internal coding audit:

Rule 1: Select charts randomly.
Ask a staff member to pull a patient list for a week, and pull every fifth chart until reaching 10. This will help ensure that the charts are truly a random sample.

Rule 2: Don’t review your own charts.
Reviewing your own charts makes it nearly impossible to be unbiased.

Rule 3: Use the same rules as the auditors.
Medicare and private insurer auditors may interpret guidelines differently, but they generally stick to using whichever E/M documentation guidelines are most beneficial to the physician when auditing.

Rule 4: Keep coding audit results professional and educational.
An open discussion on what can be improved should directly follow the review and study of the results from a physician’s coding audit.

Rule 5: Work at correcting errors.
Serious effort must be given toward fixing the problems that are identified.

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