Keep Your Queries Clinical
Question: Can I mention coding guidelines directly when querying a physician? I feel like it would help so much to show, from the outset, why I can or cannot code something a certain way. Alaska Subscriber Answer: No, mentioning coding guidelines may be considered a directive query, because you’re telling a provider something instead of asking them. Coders know that they shouldn’t ask providers leading queries, but it’s easy to do so when trying to be polite — “please document” — or when trying to couch your query in coding guidelines or other nonclinical considerations, said Marianne Durling, MHA, RHIA, CPC, CCS, CDIP, CPCO, CDEI, CIC, in her DOCUCON 2025 presentation “Queries Gone Bad.” “Statements regarding coding guidelines, [AHA] Coding Clinic® advice, or [diagnosis-related group] DRG impact have no place in a provider query since that information is only relevant to the coder,” she said. She recommended coders utilize a template or templated language, so everyone’s using the same phrasing and terminology, and to make sure queries are phrased as actual questions. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
