Wiki Just Coding

[annr420]

As a Coder, I often abstract E/M levels, Procedures and Diagnoses from reports.
If I never see, or have knowledge of the Payer's responses to the claims I have coded, how do I know if I am coding these encounters correctly and within the AAPC Code of Ethics?
In short, what external response is required to recognize an AAPC certified individual as a competent coder?
Just being certified does not seem functional in the work place to me.
How does the AAPC feel about certified coders that are hired to "Code Blind" without ever seeing, knowing, and/or having access to Payer Responses to the claims they have coded?

 

[fredabrinson]

In positions I have held where I was not responsible for the posting, I would ask to be notified of any denials due to coding were on the EOB. I also went one step further and would periodically review all EOBs, looking for large adjustments or zero payments.

But also remember that just because a code is denied does not mean it was coded incorrectly. Some payors have rules no coder seems to understand!

When I am in doubt of correct coding, I will ask someone I have confidence in as a coder, or post the question on a trusted website forum, such as AAPC or HCPro. I would not necessarily take the advice given, but it would give you other options to research to help answer your questions.