Wiki Extent of Medical Biller's job description

[sjooemmy08]

Hello, I just don't understand if it's on the job description of a biller, so please share your opinion, fellows.

I just got a call from my boss, saying I've been using the wrong CPT codes for immunizations.
But I swear that I used the right code what my providers designated. So I asked what does it mean I used the wrong code.

It turns out to be that the person in charge of checking vaccine inventories and recording designate wrong CPT code,
and doctors just looked up the list in our EMR system and chose the vaccine.
Then the encounter was locked and it popped up automatically made into a claim.
I checked the PN, immunization record, and everything matched of course.

My boss was thinking it was my fault I did not check the actual vaccine packaging to verify if the CPT code was entered correctly.
Do you guys all check the actual box and the Lot Number recorded in the EMR system?

 

[csperoni]

You job description is basically whatever your employer decides it is.
In 10 different practices, billers might perform different job functions. Some do data entry only. Some scrub claims. Some write appeal letters. Some follow up on unpaid claims. Some post payments. Some call patients with balances. Some do authorizations. Most do a combination of several of these things.
What's not clear to me is exactly where the error took place.
Do I expect a biller to verify on the actual box (that is now in the garbage) what the lot number was? No
Do I expect a biller to know if the physician documented "Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (TDaP)" but actually administed only Tetanus and diphtheria toxoids (Td)? No
Do I expect a biller to know if the EMR documetation states "Tetanus and diphtheria toxoids (Td) CPT 90715" when really it is CPT 90714? An experienced biller, probably. A coder, definitely.
If that final scenario describes what happened, the biller or coder should have queried the clinician. If an error in the EMR system was discovered, it should be corrected to avoid future mistakes.

Some EMR systems will populate CPT codes and/or ICD10 codes when the clinician types certain words. Those are often not 100% accurate. Coders should be able to correct the codes without query to clinician, provided the words are there.
Real world example. I work in gyn oncology. We often see patients with uterine fibroids. The clinician types the word "fibroid" and D21.9 pops up at the top of the list.
D21.9 is benign neoplasm of connective and other soft tissue, unspecified
I expect my billers and coders to know the correct ICD10 for this is D25.____ leiomyoma (fibroid) of uterus.