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Wiki real need for coder

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chewri

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I work at a ASC and we just got a new administrator. She is questioning me on the need to have a certified coder and says when she worked here before ( she was previously administrator at this site over 2 years ago) they didn't have a coder they just went off from what the office sent down to bill the insurance companies. Of course she caught me off guard with this question so did give a few reason but have thought of a few others after this conversation. I am just wondering what would be the best way to reply to that question. In talking to her I realize she really has no idea on what is involved in the coding world. Any suggestions for answers to reaffirm to her that a coder is needed would be very much appreciated.
 
You could hire a respectable coding audit company, submit a dozen notes with the codes the other offices/doctors assigned and then submit with the codes you assigned and show the comparative audit results to the administrator - that would do the trick. But, without that, there are online articles, etc., that you can show her as a reference (see AAPC, Becker's ASC, ASCA, etc.) that would highlight the need to use a coder familiar with the unique rules and regs about coding for ASCs vs. using the professional codes and modifiers from the surgeons' offices. (There's a reason why AAPC has a separate certifications for ASC coders.) The fact that she is considering using other offices' codes is frightening in so many ways - how do you know that their coders even read the op notes? This is setting your business up for attention that you don't want, liabilities that you don't want, the potential for government representatives in dark suits showing up at your door and A/R suffering because of incorrect coding and then denials. Then there is the issue of contracts you have with payers - and if you have carved out supplies or implants in contracts to be able to separately charge for them...facilities sometimes do that...not offices billing solely for professional fees. Even the proponents of Computer Assisted Coding programs state that they cannot replace the living and breathing coder who ultimately is the only one who can make the correct coding choices. And all of this is before the additional work and complications of correct ICD10 coding. Good luck. Hope this helps.
 
Appreciate the input. I will look at those area's you pointed out and go from there. I would love to have the other people who work here do some coding as if I were not here and see what there out come is but don't know if the administrator would go for it. Very frustrating to say the least.
 
Do a search on google for the importance of coders or

why practices need the support of a certified coder, or the like. Use them help you formulate a good answer. What a way for the new administrator to start a new relationship with employees, sheesh.
 
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