Coding Accuracy and Productivity

WandaJ

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Afternoon!

I'm wondering if anyone has standards for coder accuracy and productivity. We're looking at changing ours and would like to see what everyone else is using. Any links to professional sites on these topics would be greatly appreciated.

Thanks...wj
 

wbrodsky

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For coding accuracy, when it comes to E/M codes, my team uses Novitas' E/M Interactive Tool Sheet. If you google it, you will find it (the link for it is huge). As for productivity, if they are coding from scratch (meaning not using pre-coded claims and checking for accuracy) then I would recommend a goal of 30-50 a day. If they are coding claims that already are coded from the office and they are just basically cleaning them, then 130-150 should be a reachable goal.
 

WandaJ

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Thanks, great information. I'm also looking for percentages for the accuracy. For example, 95% minimal accuracy for outpatient coding.
 

Chelle-Lynn

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At the conference in Anaheim earlier this year, the topic of accuracy was discussed. The most common percentage expected was 95-97% accuracy.
 

cfitzgibbons

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At the conference in Anaheim earlier this year, the topic of accuracy was discussed. The most common percentage expected was 95-97% accuracy.

I have a followup question. Let's say that a coder reviews 500 charts a month. The QI people only reviewed 5 charts of these 500 and found 2 missed coding opportunities. Would the accuracy be based on the 5 since that is all that is reviewed?

Thank you.
 

Chelle-Lynn

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5 charts out of the 500 they reviewed seems like a small percentage to based their accuracy on. Personally, if I were to find 2 out of 5 as incorrect which is a 40% error ratio...I would open the sampling up to a wider group of accounts. It is possible that the 2 accounts were a fluke and their overall consistency is better or you may find that that the 2 accounts represent a wider problem that requires additional training.
 
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