Wiki Productivity Metrics

[anom]

Hey guys, I passed my CPC a year ago but landed an E/M coding role a few months ago. I am the only coder on the floor in my area, my manager and supervisor are not coders and have no hands-on experience with coding.

I rely on coders/auditors/physician educators in other areas for guidance which is fine. I work from a few different work queues that are specific to IP/OP E/M visits as well as coding denials, I run/work 2 other reconciliation reports and now have to audit and follow up on work from another department. It is a bit overwhelming but I'm rolling with the punches.

The issue is... I'm being asked to document/screenshot every detail of what I do so I can create a coding job aid/manual/tip sheet for the department which should include productivity. This is my first coding role, I have no idea what the average number of accounts per hour or per day an E/M coder is supposed to complete. I don't even know if other new coders are tasked with running and working on other reports, auditing the work of other departments, and working on denials.

I accepted the position to get my foot in the door. I"m learning as I go but some things I do not know. Other coders have not responded to me when I asked them, so I figured someone here could offer some insight on how many accounts coders are typically expected to complete per hour, day or week. Whichever LoL thanks!

 

[csperoni]

This subject has come up on the forum on several occasions. Try searching "productivity". There are a lot of factors going into how much a coder can code in an hour/day. IMO very generally, coders should be able to code E&M services in the ballpark of 12-15/hour. Surgeries (can vary a lot depending on if you're coding complex neurosurgery vs 15 appendectomies in a row) ballpark 4-6/hr.
Here are some examples of variables that could increase or decrease my expectation:
1) How well do the providers document? Some clinicians get it and all you have to do is assign the codes - all there in black and white. Other clinicians you may have to send 10 queries a day.
2) Are coders doing it all start to finish? ICD10, CPT, HCPCS, modifiers? In some situations, the clinicians provide codes and a coder simply reviews. Are they coding in office procedures in addition to E&M?
3) Computer systems? Are you using 1 fully integrated system that feeds you the work? Or do you use 15 different systems? Do you manually run a report for the encounters, then log into another system and individually look up each account, code it, then data entry that in system #3? Some systems have built in rules that basically act as an encoder to help eliminate things like excludes notes errors in diagnoses.
4) Experience and/or specialties. For example, someone who codes ortho all day long will get familiar with many codes and not have to look them up each time. Someone who codes ortho and IM Monday, ob and GI Tuesday, surgery and plastics Wednesday, endo and GI Thursday, neuro and cardiology Friday is not going to be nearly as productive.
5) What other tasks are they performing? Are they expected to take patient calls? Does your company have daily 1 hour mandatory meetings? Do they need to confirm insurance? Are they doing any authorizations?

Also remember if I expect E&M coding of 12-15/hr, that does not mean an 8 hour shift will be 96-120. I probably expect more like 72-90/day - allowing for breaks, email, etc. I have seen a lot of variance. Some people have posted they are expected to do 30 charts per hour. Some companies use accuracy metrics only.
AHIMA came out with this article a few years ago about coding productivity.

 

[anom]

This subject has come up on the forum on several occasions. Try searching "productivity". There are a lot of factors going into how much a coder can code in an hour/day. IMO very generally, coders should be able to code E&M services in the ballpark of 12-15/hour. Surgeries (can vary a lot depending on if you're coding complex neurosurgery vs 15 appendectomies in a row) ballpark 4-6/hr.
Here are some examples of variables that could increase or decrease my expectation:
1) How well do the providers document? Some clinicians get it and all you have to do is assign the codes - all there in black and white. Other clinicians you may have to send 10 queries a day.
2) Are coders doing it all start to finish? ICD10, CPT, HCPCS, modifiers? In some situations, the clinicians provide codes and a coder simply reviews. Are they coding in office procedures in addition to E&M?
3) Computer systems? Are you using 1 fully integrated system that feeds you the work? Or do you use 15 different systems? Do you manually run a report for the encounters, then log into another system and individually look up each account, code it, then data entry that in system #3? Some systems have built in rules that basically act as an encoder to help eliminate things like excludes notes errors in diagnoses.
4) Experience and/or specialties. For example, someone who codes ortho all day long will get familiar with many codes and not have to look them up each time. Someone who codes ortho and IM Monday, ob and GI Tuesday, surgery and plastics Wednesday, endo and GI Thursday, neuro and cardiology Friday is not going to be nearly as productive.
5) What other tasks are they performing? Are they expected to take patient calls? Does your company have daily 1 hour mandatory meetings? Do they need to confirm insurance? Are they doing any authorizations?

Also remember if I expect E&M coding of 12-15/hr, that does not mean an 8 hour shift will be 96-120. I probably expect more like 72-90/day - allowing for breaks, email, etc. I have seen a lot of variance. Some people have posted they are expected to do 30 charts per hour. Some companies use accuracy metrics only.
AHIMA came out with this article a few years ago about coding productivity.

Thank you. As a new coder, this was insightful. Much appreciated!

 

[TThivierge]

Hi Anom,
Csperoni gave you great advice! Id like to share my thoughts. I;d create a hardcopy booklet and E file on each medical special outpt. vs inpatient coding to use as a guide. Does your system have a Encoder but need ICD10 hard copy manuals too. Hope so. Creating coding cheat sheet per specialty help but must keep them up to date. Also new coders or all coders should have an orientation sheet with check off to ensure they know what is expected per the national coding convention rule, your facility's productivity, and other important items required there. I d make them sign it and help use for doing annual evaluations. You can create an excel form for each coder on amount code Mon-Friday then turn hardcopy into you at end of month to put in their folders. Plus they can keep one for themselves to monitor progress.

Also just give each coder a notebook/manual with copies of how to operate EHR system, basic coding tips per medical specialty, work rules, Etc as reference manual. Ensure the coders know how to use references from the NCCI, CMS, OIG and payers requirements or add to manual. Or send article regarding coding tips per specialties to add it to reference manuals Each coder could give their physician emails weekly like every Monday if notice conflicting or confusing data when coding their documentation the week before. Read up on how to query physicians...there is a certain format.

By the way are your coders remote or inhouse?

At my workplace ...inpt claims 20-30 a day, outpt 70 a day and surgeries 30 a day is productivity goal. I 'd divide coders up with coding certain specialties if possible and trade off coders specialty after 2 years or so. At my last job we were assigned physicians with their inpt.or outpt. work of documentation with certain specialties.

Auditing is a large piece to handle alone. Are you auditing clinical staff or just staff coders? Also I d run product report of most used CPT for each specialties and compare AR report . Ensure use sequencing is followed proper use of modifiers and Z codes per medical specify, add some acronyms and terms . Watch insurance denials per med specialties. You can Goggle online some coding tips per medical specialties and audit formats per inpatient or outpatient settings. Also to help you be more organized I d run audits on coder every 90 days (10 records to review per coder) or clinical staff every 90 days in a systematic approach. Each coder could give their physician emails weekly like every Monday if notice conflicting or confusing data when coding their documentation the week before. Id have face to face meeting each year with physician and clinical staff on new dx codes or CPT to review or create some Power Point slides.

Ok I hope helped you to think of some issues regarding auditing and monitoring.

Lady T

 

[amyjph]

This subject has come up on the forum on several occasions. Try searching "productivity". There are a lot of factors going into how much a coder can code in an hour/day. IMO very generally, coders should be able to code E&M services in the ballpark of 12-15/hour. Surgeries (can vary a lot depending on if you're coding complex neurosurgery vs 15 appendectomies in a row) ballpark 4-6/hr.
Here are some examples of variables that could increase or decrease my expectation:
1) How well do the providers document? Some clinicians get it and all you have to do is assign the codes - all there in black and white. Other clinicians you may have to send 10 queries a day.
2) Are coders doing it all start to finish? ICD10, CPT, HCPCS, modifiers? In some situations, the clinicians provide codes and a coder simply reviews. Are they coding in office procedures in addition to E&M?
3) Computer systems? Are you using 1 fully integrated system that feeds you the work? Or do you use 15 different systems? Do you manually run a report for the encounters, then log into another system and individually look up each account, code it, then data entry that in system #3? Some systems have built in rules that basically act as an encoder to help eliminate things like excludes notes errors in diagnoses.
4) Experience and/or specialties. For example, someone who codes ortho all day long will get familiar with many codes and not have to look them up each time. Someone who codes ortho and IM Monday, ob and GI Tuesday, surgery and plastics Wednesday, endo and GI Thursday, neuro and cardiology Friday is not going to be nearly as productive.
5) What other tasks are they performing? Are they expected to take patient calls? Does your company have daily 1 hour mandatory meetings? Do they need to confirm insurance? Are they doing any authorizations?

Also remember if I expect E&M coding of 12-15/hr, that does not mean an 8 hour shift will be 96-120. I probably expect more like 72-90/day - allowing for breaks, email, etc. I have seen a lot of variance. Some people have posted they are expected to do 30 charts per hour. Some companies use accuracy metrics only.
AHIMA came out with this article a few years ago about coding productivity.

This is spot on advice. If you are doing all of those tasks it will not be very productive in my opinion. As Christine mentioned there are a lot of variables to this. It seems a bit much to ask someone who is new and in their first role to do the all the things you are being asked to do as you describe above.

Here's one thread where it was discussed: https://www.aapc.com/discuss/threads/coding-benchmarks.189988/?view=date#post-520157

 

[anom]

This is spot on advice. If you are doing all of those tasks it will not be very productive in my opinion. As Christine mentioned there are a lot of variables to this. It seems a bit much to ask someone who is new and in their first role to do the all the things you are being asked to do as you describe above.

Here's one thread where it was discussed: https://www.aapc.com/discuss/threads/coding-benchmarks.189988/?view=date#post-520157

Thank you Amy. I 'm a fast learner. I don't furrow my brow when asked to do more than what is expected. But I'm aware of when I'm getting the short end of the stick and I do feel this is a bit much ,specifically because there is no one in my department who can teach, correct, or assess the quality of the tasks I've been assigned. Performance reviews are in a few months and I'm interested to see how that pans out. I want to develop my skills but I also want to be certain that what I touch is accurate and efficient so that I'm equipped for other coding opportunities in the future.

I appreciate your time and response. I'll check out the article you shared as well.