Hematology/Oncology Coder Productivity and Accuracy Requirements

[saria121976@gmail.com]

My office hires a lot of newly certified coders who have never worked as a coder. Typically, they have worked in other areas of the office, for example insurance verification, prior authorizations or working rejections. Our oncologists, hematologists, surgeons, etc. are responsible for selecting their own CPT codes, and our coders read the notes and add the ICD-10-CM codes and modifiers for E/M and office procedures. New coders have intensive training for 2-3 months with every code they select being audited before the visit is billed. We ask them to work up to a benchmark of coding 25-30 patients per day by the end of 30 days and 50-60 patients by the end of 60 days. Several struggle with these benchmarks and are only able to code 10-20 patients per day in the first 30 days. I'm also curious if you have accuracy requirements, and if so, what those are. I'd like to hear what other office expectations are.

 

[TThivierge]

Saria
I think up to 50 to 60 claims a day for OutPt. sounds good.If doing Inpt claims might be lesser amount of claims completed per day. Ahh when abstracting if outpt. claim do they code the lab and xrays if order by the same provider same day? Or are some coders assigned to do coding of just lab or xrays? Are the coders expected to code one medicine specialty or assigned a certain amount of providers to do all their inpt or outpt coding? I think it works more efficiently if give each coder assigned medical specialty then after 6 months trade it off for another medical specialty. Or some sites give each coder a bit of all medical specilites....depends on your policy& procedures there. At my hospital I was assigned 8 providers outpt office in their network. Another place i worked assigned a bit of 6 differ medical specialties. We did have cheat sheets to help us on medical coding certain specialties. Currently I abstracting clinics must do 70 records a day and send query emails if documentation is missing some vital data.
I hope I helped you
Lady T

 

[saria121976@gmail.com]

Hi Lady T,
Thank you for your response! This is helpful Our coders typically code for one or two specialties for outpatient office visits and procedures performed in a physician office. They are assigned 2-3 providers and only code the E/M's, which can be 50-80 patients per day. There are billers who bill the labs, xrays, etc.

What are the expectations for new employees?