Accuracy of coding decline

espforu

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Local Chapter Officer
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Good Afternoon/morning!

I do post payment audits to track the accuracy of our physician coding and educate them but for the last few months I have seen a decline in the accuracy of their coding. I am at a loss and was wondering if anyone can make any suggestions of where to start. I generally look at each provider individually and try to understand how they are coding. Sometimes they misunderstand New/Est patients or the data points, etc.

I am wondering if I am missing something. Any suggestions would be greatly appreacaited :)

Kim:)
 

LLovett

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One area you may want to look at is the EMR. I have seen updates on EMR systems that had unintended consequences. Things like exams being dropped or a box the provider checks to populate time is no longer populating the time in the note, it just looks like it did when they are documenting. Once the note is final, poof, it disappears. There are a lot of little quirks that can happen.

Another culprit could be bad information. I have seen trends where providers have received and passed around bad information causing major shifts in their coding accuracy. Fear can do this as well, if they have heard about a peer being audited it may cause them to start undercoding in an attempt to stay off the radar.

Just a few thoughts, good luck!

Laura, CPC, CPMA, CPC-I, CANPC, CEMC
 
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