Outpatient Coding Laboratory Practices


True Blue
Best answers
There isn't any regulation or compliance guidance that I'm aware of that requires codes to be selected only by certified coders, and in fact it is very common in many provider organizations to use non-certified staff to perform many of the more basic coding functions. Because of the higher cost and low availability of coders in some areas, organizations may choose to just use coders for auditing, quality improvement and educational roles, rather than having them perform all of the coding-related functions.

There really isn't anything wrong with that as long as there is a process in place to control quality. I think the concern should not be about whether or not the person is certified, but rather whether or not the work is being done correctly. In your position, I'd take the approach of wanting to make sure the organization is conducting regular audits to monitor and ensure quality and compliance. If those audits are showing problem areas that require specialized skills to correct, that's where you'll be in the position to make your case that certified coders are needed.