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Coding For Hospitalist Group

  1. #11
    Medical Coding Books
    I have recently started working for hospitalist group. we have more than 25 Internist going to few different hospitals and I am just trying to figure out how to be beneficial with my knowledge and how to develop coding department, who does medical chart review, auditing and review physician who are lower coder to educate them to improve on MDM and documentation strategy. Anyone outthere have similar objectivity who would like to share more?

  2. Default Feedback
    I've done work for Hospitalist Groups and several others on here have done coding for them. My experience is Hospitalists probably shouldn't be doing their own CPT coding, but most practices still do. And it sounds like that is the case with you. So what I've done is;

    - Develop an E&M spreadsheet by provider (looks like you have done that). Identify outliers both on the low and high end.
    -Audit a sampling of each providers coding to the chart documentation
    -Based on findings develop an in service for the providers focusing on documentation and coding.Meet individually with the problem providers with actual documentation/coding examples
    -Establish a monthly meeting to review overall trends in E&M Levelling etc
    -You might also do a more complete integrity audit to see if there are missing charges. This would be tracking a sampling of the hospitalists coding from the chart through billing to see if there is a need to develop an improved accountability process.

    The problem areas I have seen have included under and occasionally over coding of Levels. Simply incorrect coding where the provider will use the same Level throughout the hospitalization. Incorrectly coding discharge day services. and a lack of understanding of Observation and Critical Care documentation and coding. And typically significant provider turnover requiring an ongoing credentialing/education process. But besides that there are no problems! As I stated above they probably shouldn't do their own coding..

    Jim Strafford

    Good Luck

  3. #13
    Oh I am so sorry, I am still newbies to these so didn't see your generous response earlier. I greatly appreciate your feedback. Yes I am going to follow and integrate few points that you mentioned in my auditing. Goal is to increase revenue, avoid being audited and of course to improve without compromising quality of care.

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