Message From Your Region 5 Representatives | Sherrie Anderson & Vanessa Moldovan
Hi there members of region 5! As we fall into November, looking back, where has the year gone? As you are nearing the end of 2019, from a coding perspective, let’s think about opportunity for coding improvement in 2020. In efforts to improve, we should consider common coding issues. There are common problems within the coding and billing field that lead to an impact in the bottom dollar. The first key item to consider is communication. Not communicating clearly to each other and / or within documentation leads to break down. As a coder, we have to be capable of effectively communicating to our team and our providers. For example, if a note is lacking key information, we should communicate with our provider(s) and provide feedback because (s)he may not be aware.
The next key item is updates. We should be aware when code sets are updated, changed, or revised. It is crucial to code with accurate code sets to receive reimbursement. Guidelines can change frequently and staying abreast of such changes will lessen denial rates. Know the policies and know the guidelines. We should be working hard to keep our minds flexible, and adapt to change. Be prepared for things known and be prepared for the unknown.
How about under coding? Under coding is billing lower levels or fewer services to prevent denials, and is more common than one would imagine. Sometimes, providers like to be overly cautious. Be sure your practice is not under coding in efforts to prevent denials or play it safe. Under coding is deemed fraudulent, and no different than over coding. This can and will lead to audits, as well as any investigations, fines, etc. Don’t play it safe, play it right.
As a coder, we have a tough job. We are the coder, biller, educator, communicator, mentor, and the specialist. Staying detailed, organized, and communicating clearly will help prevent some of these common coding issues. We, your region 5 NAB representatives wish you and your family a very happy fall harvest.
Sherrie Anderson MS, CPC, CPC-I, CPPM
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