Top 10 Pet Peeves of a Medical Coder

Top 10 Pet Peeves of a Medical Coder

Use your job-related pet peeves to initiate better communication in your healthcare organization.

Pet peeves are things other people do that annoy you. I’m sure you can think of lots of things your physicians do that get on your nerves. Here’s my top 10 list of a medical coder’s pet peeves, with tips for resolution.

No. 1 Unclear or Illegible Clinical Documentation

Medical coders want to select the correct diagnosis codes properly linked to treatment, procedures, and services. We do not want to abstract coding information from a checklist of symptoms (superbill) because there are no details to describe the given treatment. Most of us know the medical coder’s mantra: “Not documented, not done.” Providers must complete clear, concise, and detailed documentation in each medical setting and sign/authenticate the record in a timely manner. Clinical details, such as the trimester of a pregnant patient, are relevant and important to proper coding.

Tactfully address your concerns with your provider and offer training on clinical documentation improvement.

No. 2 Physician Is Slow to Respond to Queries

Physicians who do not respond to queries in a timely manner prevent you from doing your job, which decreases your productivity.

Explain to providers how their actions affect them: Not responding to your queries ultimately delays their reimbursement.

No. 3 Missing Diagnoses Codes

Missing a diagnosis because the computerized assistance coding (CAC) encoder system does not tell you which diagnosis codes need an additional or underlying diagnosis code. The missing detail can affect reimbursement.

Confirm diagnosis codes using a current ICD-10-CM code book, which includes “code first,” “use additional code,” and “code also” instructions. Reference sheets and other such coding resources also work well if you code consistently for the same assigned medical specialty.

No. 4 Documentation Supports a More Specific Code

The provider selects an unlisted CPT® code when documentation supports a more specific CPT® code. This could lead to denials due to suspected code unbundling and potential compliance violations. Unlisted CPT® codes should not be assigned on a regular basis.

In a scheduled meeting, tactfully explain to providers how unlisted codes affect claims payment.

No. 5 Too Many Diagnoses

If more than 25 diagnosis codes are assigned for the inpatient record or more than 12 diagnoses for the outpatient CMS-1500 claim form, the medical coder must remove diagnoses to transmit the claim.

Tactfully explain to providers that diagnoses must be in correct sequence and follow national coding conventions standards.

No. 6 Lackluster Support

Coding requires concentration, and medical coders who are assigned too many tasks — answering the phone, processing insurance denials, verifying insurance, and posting payments — will struggle to manage stress and do their job productively.

If you feel overwhelmed and your productivity is suffering, speak up for yourself. Present your employer with evidence that supports your claim. For example, does your original job description include all the duties you are doing now?

No. 7 No Compensation or Time Off for Ongoing Education

Coding accuracy is crucial to reimbursement and compliance. It’s to the organization’s financial advantage to encourage coders to stay up to date with frequent coding and compliance guidelines by offering compensation.

If your employer doesn’t offer compensation for continuing education, ask for it! Present your employer with the specifics: what you’ll learn, how much it costs, and how it will improve your ability to do your job.

No. 7 Criticism for Using Reference Sheets

Criticism for using a coding reference sheet or insurance rules is unfair because using so-called “check off reference sheets” are a much better solution than relying on memory.

Explain to naysayers that, although the CPT® and ICD-10 code books are necessary resources, more concise and targeted coding resources are a big productivity advantage for coders who see many of the same types of claims.

No. 8 Office Noise and Office Drama

Concentration can be difficult in an active office. Having to read and reread a physician’s note, for example, because you can’t concentrate can be very frustrating.

Consider wearing headphones to help block out noise. Be careful about listening to music, however, as it may distract you or cause a coworker to develop a new pet peeve,  people who sing at work.

No. 9 Diagnosis Does Not Meet CPT® Medical Necessity

It’s a problem if the provider’s documentation does not support the link between the CPT® and ICD-10-CM codes.

In this case, query the provider for more information and hope you don’t experience pet peeve No. 2.

No. 10 It’s Not Complaining when You Have a Solution

Pet peeves are an out-of-the-box way of identifying communication red flags. If addressed, they provide an opportunity to improve productivity and employee satisfaction. Rather than treating pet peeves as irritants that we ignore, think of them as problems to solve. Use pet peeves as discussion points to educate and provide understanding about your job, to enhance your critical thinking, and to foster communication between upper management and clinical staff. When work site pet peeves are brought to the forefront, it affects everyone’s medical office politics while considering the rights and needs of others: the clinical staff, the patient’s privacy, the coder, and fiscal implications. Share your job-related pet peeves to influence work behavior and cultivate unity.

Got a pet peeve? Share it in AAPC’s Facebook Group.


Tamara Thivierge, MHA, CBCS, CPC, is a medical claims auditor for Community Health Center Network in San Leandro, Calif. She has more than 20 years of healthcare experience in professional coding and revenue cycle management. Thivierge is a member of the San Jose, Calif., local chapter.


Resources

Bernard, Sheri, CPC, COC, CDEO, CRC, CPC-I. June 2008. AAPC. The Work of a Coder; Survey Comments.

Cassidy, Bonnie. 2012. AHIMA. Defining the Core Clinical Documentation Set for Coding Compliance, https://bok.ahima.org/PdfView?oid=105782

Chapman, S. January 2014. For the Record. Beware of Poor Coding Habits, Vol 26. No. 1. page 20, www.fortherecordmag.com/archives/0114p20.shtml

Hill, Emily PA-C. March-April 2011. Family Practice Management. Five Common Coding Mistakes that Are Costing You, www.aafp.org/fpm/2011/0300/p31.html

Morrissey, John. June 2012. Documentation, Hospitals & Health Network, pages 6, 24-29.

Perna, Gabriel. August 1, 2016. Physician Practice. Physicians Reveal Pet Peeves About the Job, www.physicianspractice.com/physician-productivity/physicians-reveal-biggest-pet-peeves-about-job

Pounder, Deb, RN, CPC, CPMA. December 2016. AAPC. Healthcare Business Monthly. pages 14-16. Professional Development Is A Perpetual Endeavor, www.aapc.com/blog/37140-37140/

Allnurses.com, ER Pet Peeves, October 2005, https://allnurses.com/er-pet-peeves-t91684/

AAPC's annual salary survey gives a good understanding of the earning potential within the medical coding profession.
See what actually is going on in the healthcare business job market.

Leave a Reply

Your email address will not be published. Required fields are marked *