I am in one of 9 clinics. We have a coding department that codes for ER, lab, x-ray and some other departments, but my clinic and other clinics code our own tags and it goes to our billing department to review. In this department there are CPCs....
I am a Coder who also holds the titles of: Privacy Officer, Birth Certificate Clerk, Voluntary Declaration of Paternity Clerk, Transcriptionist, Quarterly Report Clerk, Birth Defect Network Clerk, Newspaper Article Writer, Assistant Supervisor HIM
I work in the Information Technology Systems Dept. I do all the "behind the scenes" set-up for EMR and create all the insurance benefit plans for our billing dept. This requires knowledge of CPT, ICD-9 and HCPCS codes. Assist in creating rules for billing charges, using LMRP/CCI policies. Earning my coding certification has been my most valued accomplishment! It goes a long way!
I work for a payer. My major responsibility is ensuring that the we meet our contractual obligations to our contracted providers. This includes reviewing payments made to those providers to ensure that reimbursement isin accordance with our contracted rates, policies, and correct coding practices. I find that there is very little education aimed at certified coders in the payor-world. A focus on coding from the payor perspective would be a great value add and maybe induce more of us to seek the credential.
Some providers welcome input from coders, others detest it. Those that destest it want to shoot the messenger; they're frustrated with rules and regulations.
I think that my work is very important,and the coming of electronic medical records scares me because I think doctors are going to want to replace the coders completeley with the machines.
I work for a Medicaid Managed Care Organization. I am currently the only certified coder on staff. My job title is Business Process Analyst. My responsibilities includes analysis of claims submission from providers to find incorrect coding patterns and educate the provider groups. I recently arranged for a PMCC coding class to be taught here and the students took the exam this past weekend. I am hopeful that all have passed and that we will have 8 certified coders on staff soon.
I share coding responsibilities with a newer certified coder (we are under new management after 10 years of chaos with lots of new employees) and I am taking the certification exam 2/16/08. I feel that once I have the credentials, the physicians may have more confidence in the work I am doing.
I am not certified yet but will probably do it this year. I have been attending and coding for about 5 years. I did take the test once, but failed to retake within the year. Coding is a very challenging field and has so many componets that need to be completed. I feel that doctors do not realize we are a key component to a great office.
I think it might be interesting to ask doctor to coder ratio. For instance I am the only coder\biller for 2 doctors and a nurse pratictioner.
In subrogation there is a need to know coding to be sure that all related claims are properly submitted, for medical reimbursment on behalf of the medical provider, to the proper insurance carrier or person responsible for the injury. This is also necessary for court cases and attorney litigation when reimbusement and settlements are being decided. If you don't know the code or its meaning you cannot audit and submit the correct billings.
I work in workers compensation insurance so I deal with many different providers, from hospoitals to pain clinics, first treatment centers, orthopedics, neurology. Most of what I review are evaluation and management visits to different specialties. It is a very diverse group and I see a great spectrum of coding practices. Also I am the only coder in the office and do desk review of any automatically down coded office visits.
I am an ER coder and I am responsible for capturing all facility and professional charges plus assigning the diagnosis code and abstracting the record per the documentation in the ER chart. I never speak w/the insurance carrier and only review a denial when a biller requests review, changes are only then made by me if something has been missed. Codes are not changed to get the procedure reimbursed as this would be fraud.
The coders here are on a time schedule due to data entry that needs to be done by a certain hour so we do not have the time to really scrutinize our work so we therefore do have errors which are returned to us as edits.
I perform chart audit for E&M, usually post audit review. I also do random pre-audit during my review of all edits for charges billed to insurance. I assist with reports by my manager for physicians.
I work for an anesthesia providers who bill based on base units plus time. We very rarely have any E & M coding. We are in a billing office and do not have direct contact with the providers. If we need them they will return our call.
Manage the practice, comtribute to policies and procedures. Work with all levels of the department. Educate and re-educate as policies change.
I do the Medicare billing and A/R for our hospital and clinics. We have professional coders that do the coding and other people who do data entry. I have to edit the claims so they go out clean. If a code is incorrect I send it back to the coders. I also do some training for providers and I am on the compliance committee.
I have worked for a larger office, and I prefer the smaller office. The providers seem to care more about me as a person, not just a number. It is much easier to form a relationship with the providers and discuss codidng issues with them in a smaller office.
I am the only coder at this clinic. No one else in my department is certified or helps with the coding/data entry. My providers are slowly coming around and taking the time to sit with me and go over their mistakes. The coding they do is minimal and I do view every superbill before data entry is completed for claims approval.
I am in education, teaching insurance and coding at least 30 hours for two semesters.
I work in a government (Medicaid) environment doing CMS-mandated post audits. All the questions concerning interaction with physicians/providers are not applicable to the description of my work.
I am a coding float/trainer - filling in for vacations and also training new coders.
My office has recently changed to Rural Health Center after many years of private practice and so I am leaning a whole new set of rules from Medicare etc. very interesting utilizing all the systems we use for coding.
Working as an inpatient coder and doing more that just coding. Perfrom length of stay reviews to insurance companies, assembling charts prior to coding, attempting to start a concurrent coding process which seems to have lots of repeated functions and less time spent on actual coding.
New Practice: A compliance plan, educating the providers and staff will be imiplemented. Would like to see articles on 1,2,3 setup of a plan.
Oversee a 9-employee billing company. Billing company currently has 10 separate clients of different specialties.
I'm involved in program and operations auditing of other provider offices billing claims to our health payor.
Up until very recently, I had been working for a payor in their Fraud Investigations Unit. Obtaining and keeping current with my CPC proved extremely valuable when identifying inappropriate coding schemes.
Auditing records for Medicare Risk Adjustment has become a major role. There are not enough resources to aid coders regarding diagnosis questions.
I code radiology, mostly mammography, core biopsies, cyst aspirations, ultrasounds and x-rays. We recently did scinti mammographies, but no longer have the equipment in our office because of cost factors. So my coding is limited. Our office also use to do CTs but again this was moved to another location.
I no longer work for physicians so the survey is somewhat difficult to do but I do much coding with my students getting them ready to go out into the field and ready for the national CPC test.
I receive charges to key and submit for two doctors, two others are coded and submitted by another biller and an MA who are not credentialed in CPT coding. I do the follow-up on all four physicians. When the CPT and diagnosis codes are wrong, I have to have the new codes approved by the physician before I can change them. I do all the appeals, corrected claims, ect. I am not certain whether they use cheat sheets or not.
My work environment was not listed, it is a small hospital with inpatient, outpatient, and Emergency department.
I am Medical Office Manager, PCP, RMA
I am able to do every job, I code, and put charges in, I print bills, I do follow up, I so credentioling, I answer patient calls and I manage 3 people.
Please understand, coders are needed for epidemiology. We understand what the codes are trying to say. Codes are not just for reimbursement. Understanding and applying codes to the health of our population is my primary value. Thanks.
I am currently the only coder for the urgent care center. Until I started working there, they had never had a "coder." It has been quite a challenge to try and change the way the process has been handled in the past. I have gotten very positive feed back from the doctors and office staff that deal with the billing. We are currently in the process of implementing the T-system to better help with documentation. I look forward to working with another coder in the future to discuss difficult situations that arise and to use as a sounding board when trying to decide on coding procedures and the appropriate modifiers to use. I am very fortunate to be working with a terrific group of people. There are 3 urgent care facilities and I currently do the coding for all 3. I greatly look forward to new information that is put out by the Academy and try to use it to the best possible advantage. Thank you for all you do in keeping up-to-date information available.
I am an invasive cardiology secretary/CPC. I review procedures and dictation and code peripheral cases and electrophysiology cases (ICDs, pacemakers, EP studies, ablations, etc.) Peripheral cases from angiograms to interventions (SFAs/iliacs/popliteal/carotids, etc.) I would like to see more peripheral seminars available closer to home. I could attend and gain more knowledge in coding.
As compliance coordinator and medical coder as well, the responsibilities are extense, since I work at a multiespecialty clinic of 42 physicians. We are only two coders, but the providers have learned for the most part, to code their services and diagnoses. We have a well-structured billing and coding compliance plan. I constantly perform medical chart reviews for teaching purposes. The physicians are very receptive of any recomendations or advise.
In response to the review and correcting of ICD-9 codes or CPT codes, it is my responsibility to review, but when corrections are needed it is discussed with the physician and the correction is directed by him/her.
As a payer we try and communicate with providers to be more aware of our customized claim edits and reimbursement policies to reduce the amount of complaints that have to be file. We also want them to comfortable in knowing that if their cases have to be reviewed, Certified Professional Coders are reviewing the complaints.
I work for a major workers compensation company. It is important for me to educate the providers' offices with the newest of information so they will submit bills correctly the first time for the prevention of denials. I also inform our IT department of changes so our system is as current as possible. If I can streamline the bills so they do not hit snags on the way, we and the providers are happy.
Hospital coder: Code outpatient surgeries, pain clinics, oncology, some inpaitent, and help others if there is time.
I really do love my job. I have coded for a total of 25 years and the past 4.5 have been in anesthesia and even if I wish some things were different I can't think of another department I'd like to work in.
I am an instructor at a small community college. I am certified and teach medical billing and coding.
All primary providers at our facility code outpatient encounters on a daily basis, but usually low level E&M are used. I code a wide variety of providers (orth, pod, opthalm, vasc, x-rays, labs) so I was limited in my choices above.
The above information was supplied on practices that I am consulting with to assist with compliance and coding issues.
There are about 70 providers. Most of them do their own coding. I do coding for hospital surgeries of 3 providers who do not code their own. I do not get to see the denial side of coding. I would like to work the whole circle so that I will learn and understand more of the whole system. I am very new to coding, so time will tell. Thank you for this survey, I'm looking forward to the results.
We are a pediatric specialty clinic which includes Primary care, Xray, and Lab as well as Rehab (pt,ot,speech,audiology,and wheelchair). We do a lot of very complex coding.
There are five coders in my area and we code office visits, surgeries, hospital rounds and bedside procedures for the surgery department, which includes general surgery, ENT, bariatric, vascular and surgical oncology.
I educate students on the insurance coding and billing process.
Process improvement will occur as we move to the electronic record.
The survery should include areas other than a physician or facility practice. Coders provide value added services to insurance payers/administrators. Their global understanding of coding and reimbursement methodology is essential.
I have no comments at this time... thanks for asking :)
This is my first job & it is for a psychiatrist. This is her first year in her own practice so we both are learning proper codes to use at which time. I enjoy the work, but do things 2 or 3 times, because no one is available to ask the proper way the first time. I do everything from phone calls to urine samples. I wish I could find another coder in my area to ask questions. Sometimes my boss does not think I am worth the mere $10/Hr she pays me. My class did not teach me anything about a CMS 1500 so I am self-taught.
The physicians are ver active in coding their daily patients. They have access to all of my books and use them regulary.
For now, I audit providers' charts at several (28+) sattelite offices owned by a hospital. In the near future, I will be revisiting some of the intricate components of the entire practice - front desk education, physician education etc....
I am certified through the AAPC. I have enjoyed working in home health care for 23+ years, but as a medical coder with an audit team for 4 years. My boss relies on me to research and provide information about changes in regulations and updates regarding diagnosis coding, mostly ICD-9-CM codes, concerning home health care. Medicare is one of our main payers, and it requires a lot of research to keep up with CMS changes and requirements. The AAPC does not offer a specialty coding certification for home health, as of yet, so I am forced to look at other organizations for that certification and hope to obtain that this year, 2008. I wish the AAPC would offer this specialty certification.
Our provider owned company includes over 50 providers of 26 different specialties.
I am a nurse analyst auditor in the compliance department of a large specialty clinic which also includes rural health clinics. I am responsible for auditing and educating the physicians, and various department heads regarding coding, reviewing patient concerns for correct coding and compliance with Medicare/Medicaid rules & regulations. I have had many years of nursing experience, 7 years of administration experience, and this is my 5th year in this position.
Some of the questions are hard to answer as I am not a certified coder. I am also unsure how educated in coding most the the physicians are. My goal is to learn more to be able to code and bill as accurately as possible for my physicians.
I answer a multi-line phone and direct the calls to the appropriate area, put patient data into the system, make charts, discharge patients, accounts payable, file, fax, copy.
I am the bookkeeper in a nursing home. I use just some basic coding knowledge in my position. In a nursing home we have a MDS nurse who does all the coding (RUG scores) and I get my info from her regarding reimbursement levels and diagnosis codes (which I then check in the Medicare FISS System). I input all charges in accounts receivable and then I enter all claims in the Medicare system for payment and do all follow up on payment/denials. I keep up my credentials because I do not want to lose my CPC certification.
I work for a Payer and therefore most of the questions do not apply.
We are a physician billing company located on the grounds of the hospital, we enter some physician charges, we do f/u on charges and patient service
I am the practice manager as well as coding all surgeries in a 4 physician specialty office so unfortunately, I don't have as much time as I need to code.
I feel our office is short staffed in the business office. We could use another coder or another person to work insurance denials. We only have 2 coders for 8 physicans, 2 PAC, 1 RNFA, 1 ultrasound tech so time is limited to code and work denials. I see our office moving in the direction that the coders will do all the coding and the physicians will not.
I appreciate the last coders' magazine comments about paying more attention to coders working for payors as I do. From my perspective, if we all applied good coding practice to billing and reviewing claims, we would agree more, keep the lines of communication open, and understand each others' points of view. Thank you.
I work for the government. Being a coder helps me in my job, but I'm not a practicing coder. I review appealed claims and perform other claims and provider-related activites which is aided by the knowledge that I possess as a coder.
As an employee of an insurance company we work on the other side of the health care industry from providers. Nevertheless, having more certified coders at our company has greatly increased our ability to communicate clearly, correctly, and fairly with providers.
I have a full time management position in an ancillary field or health information management. I do per diem ED coding and answered these questions based on the per diem coding work that I do.
Small practice, with myself and a receptionist running front office.
I audit numerous physicians throughout a large corporation. The main focus of my job is to educate the providers and staff on anything found during the audits or any changes that have taken place in the coding/billing world. I answer their questions, researching the answer if necessary.
I work for a payor, so although coding is important, knowing rules and regulations and knowing how to research for imformation (e.g., searching the CMS website, Federal Registrar and etc.) is also very important.
Not on payroll as I am wife of the physician. Also act as office administrator. Billing follow-up is presently outsourced.
Learn as much as you can and continue to further you education.
I am the only certified coder in this practice. I have other duties I must perform, chest xrays, spirometries, and blood draws. I code the hospital charges after the nurses put them on the charge sheets. I feel my coding talents are being wasted or underused. I am a "detail" person that loves investigating and digging for information. This trait makes me a good Lab Tech and a good CPC, however, I seem to be more valued for my lab skills in this practice.
The practice I work for is in the midst switching from manual charting to an EMR system. The docs have always done their own coding. The practice had never had a CPC on staff until I came on board 3 years ago. It wasn't until the past 6 months with a severe change in management that changes have been made in terms of my job duties, salary, and misc. benefits, i.e., practice paying for my AAPC memebership and CEUs. I am now educating the physicans in compliance, documentation, ICD-9 selection vs just charge capture and coding. I am also auditing charts and educating our other "coder"-not certified-of complaince, documentation requirements, and CPT descriptor selection. I'll review charts as requested by account reps because patients call in and complain about charges. I edcuation account reps of regulations and guidelines regarding NCCI edits, modifiers, global periods, etc. I will NEVER look at an EOB in my practice. We code to code based on services rendered in the chart notes. I also codeout every single Medicare chart because of the complexities involved and the modifiers required.
I work for a healthcare software company. We provide consulting services as well as chargemaster software tools for hospitals. Our software includes comments and coding notes with regards to CPT/HCPCS coding, revenue code assignment and pricing.
I work as the only certified coder in a medical malpractice insurance company. The bulk of my coding focuses on the medical event whice lead to the malpractice claim. This information is derived from multiple sources, the claim rep (usually a nurse) who is handling the case, from the doctor initial phone call or the medical records supplied to us. This information is then entered into the required various state health reports. Our company has new guidelines for medical coders, which require certification. At present I am the only certified coder in the company. The other 2 coders who work at our home office, were "grandfathered in" when the new guidelines were put into effect. They are both excellent at what they do and have been working as coders for this company for many many years.
I code for two physicians and I do everything from data entry to collections. There are others in our office that perform specific duties but it is easier for me to do everything and know that it is done correctly the first time.
I am a practice analyst and manager for a multi-specialty (orthopaedic and pain management) practice.
Most of these questions do not apply to consultants.
I work in a billing office that has over 150 providers. My title is Coding Specialist and I work in the coding department with 5 other certified coders. Some of the providers code their own encounters, while the office managers code for some. We code the majority of ICD-9s.
Certified Coders here are expected to audit and code encounters, answer the providers questions for our clincs and provide all the education and training for our clinics.
I would appreciate if AAPC would include MT/MLT as options for credentials. Include more on Path/Lab. It is way more difficult and challenging than most people think. We require MT or MLT background for this reason.
I think that coding education needs to involve more reimbursement information such as National and Local Coverage Determinations.
The coding auditor is located in our main office. Management does care if I am certified or not.
Not only do I code, I am also the financial supervisor. I have 8 people under me, 2 of which don't do any billing/coding work. We have 6 physicians, 3 PAs and 1 NP, and 45 clinical and clerical staff. I work in a urology office. The younger physicians have a better understanding of coding and the EMR system we are on. Currently, we are without an office manager, so most of my time at work is spent on everything but coding. I take work home most nights, but I currently don't have access to the EMR system from home. I am working on getting access installed.
Would like to see education for CEUs brought on site for all 15 coders at our location
I do chart audit on E&M records for different insurance companies.
I am also responsible for updating, reviewing and maintaining the fee schedules for all of our payers.
I have completed the survey for my previous pathology/lab employment for whom I still do some consultation (10+ physicians). The physicians assign CPTs and the coders review those and add ICD-9 codes with the exception of dermatology who does their own coding and the coders will verify accuracy. Our billing office provides national support/services for the company. Currently, I am an instructor for medical billing and coding program.
I always have to review, research and read a lot of new guidelines, regulations and latest books/informations. Please keep informing members with updates. Thank you.
Due to the nature of the office I work in, the majority of these questions weren't directly applicable to coders employed there.
I have several providers so it's hard to answer these questions with all of them in mind, some of them are very good and some of them do not know much about the coding aspect. They are all educated by the coding staff regularly.
It is challenging because we are working from electronic records and learning a new system.
I work full time as a nurse, but also review the surgeon's hospital coding prior to submitting charges.
Since I work for a payer I feel most information, including things like this survey are geared toward "regular" coders and frequently don't apply to what I do. However, I believe what I do to be a very important aspect of the entire process. It isn't an easy task to go behind what someone has done, undo it to determine what is keeping it from paying or what the coder/biller did that is causing a patient benefit to be interpreted incorrectly. I would like to see more from the AAPC from a payer perspective - not just CMS.
When I refer to my provider...that would be our MD medical director.
We do auditing and consulting for physician based coding. We educate clinicians based on their audit results. We also teach a coding class at a college and in an online environment.
I would like to be able to talk about appropriate codes with the surgeons to match the code choices to their actual procedure.
I spend a lot of time educating clinicians so they will document well and give me the information I need to code accurately.
I perform Q/A for one ER ......... mostly E/M.
I have been working in pharmaceutical industries for coding of clinical trial data such as adverse events, serious adverse events, medical histories and concomitant medications, with the use of dictionaries such as MedDRA, ICD-9 and WHO Drug Dictionaries.
Acadmic practices have significant compliance and coding risks. Providers have mixed reactions to the coders due to their role. Coders must act as liasons between the providers and billing practice which creates another level to what is expected of a coder.
I work at a not for profit medical assocation in the Medical Affairs department working with staff and physicians on correct coding & reimbursement.
I am in the field 80% of the time doing inpatient & outpatient medical hospital reviews as well as the health centers associated with our MCO. Denials generated by our MCO to a physician who is making an appeal will be reviewed by an RN coder if clarification/expertise is required.
The majority of my work is veryifying that our oncology drugs are payable and I also verify all diagnostics for payability---I am continually educating providers about new rules etc. We also bill out millions of dollars of drugs and so we also audit documentation for that--making sure what we need to bill is documented--asking either providers or nursing to document.
I work for an oral surgeon, so I have to code medical and dental.
I work at a teaching institution. Coding certification is one of the minimum requirements. A few years experience is preferred. The doctors do their own E/M and ICD-9 coding for office visits and this is entered from the fee ticket by data entry staff. Hospital based services (mostly surgeries) are coded and entered by the coders. Some of the docs do turn in billing sheets (more to verify accuracy of dictation becasue op notes are dictated by residents). Any payments, rejections, appeals, etc are handled by the billing service. We frequently communicate with the billing service to assist in appealing rejections.
Low volume, specialty, 1 physician office owned by hospital ; highly educated physician in CPT and ICD-9 coding; small amount of errors found and corrected through audits.
I am the biling manager and have two front desk personnel. I recently took away from the daily charge entry because of consistent errors. This puts a heavy load on me and I often work 40+ hours to keep the department running as it should.
Need more training.
I work in a medical school physician practice. The doctors all must do their own coding--we try to help them be more accurate in thier choice of codes--It is an ongoing process--always new physicians to help.
I am involved in the Special Investigations Unit of a payer.
i work in a hospital, doing outpatient coding, hopefully training for inpatient coding. I work with 2 other coders for outpaient...and a supervisor.
I do have medical credentials, but currently I'm not in the field. I hope to be in the near future. I do work full-time, go to school, keep up my medical credentials, and (maintain a household like everyone else).
At my company we could use more training. I work for a contracted company that works for the Veteran's Administration. And we could use training classes to help with CEUs.
On a daily basis I code anesthesia and pain clinic records, post payments, appeal denied claims, report daily cases and aged A/R to the executive board, answer phones and mail and any other tasks needed to keep the office running smoothly. There are 6 full time and 1 part time employees supporting 23 anesthesiologists (and 1 resident) at a community hospital as well as a cosmetic surgeon's office and an eye surgery center. Each of us has to act in several supporting roles in order for everything to get done. There are 3 certified coders, including the office manager, and one student coder.
Fraud and Abuse
I work for the military. They do not bill. The only function of coding is for HEDIS measures. The military has it own unique way of doing many things and coding is one of them. They also have an electronic medical record that has some significant glitches in it. They don't update the codes time i.e. CPT codes for 2008 won't be available until May.
Company needs to take a closer look at responsibility of the coders in our offices and take into consideration geographical locations.
I work in a nursing home as a HIM Manager. I am the only coder in the 300 bed facility. I don't work much with physicians. I don't do our billing either. I guess I am a rarity.
I am considered a pre-bill auditor, I asign ICD-9 codes based on the initial evaluations from the providers. I check for documentation compliance and help educate the provider on proper coding and documentation.
I am the only coder in our practice. We outsource the billing. Providers depend on me to look up codes that are not listed on "cheat sheets" and to audit charts for accurate coding.
I live in a small town, but the availibilty for certified coders isn't available. The certified coders expect to get more in pay than what they are willing to pay for this area. I am working on getting my certification, but out of an office of 10 people none of us are certified including my manager.
The department I work in handles A/R follow up for over 20 specialties. Coding knowledge in a variety of areas is very important.
I worked in a Dr. office for 12 years and the coding enviroment was very different then working for a billing company. My current employer believes strongly in education and compliance. We have regular A/R meetings and monthly meetings with our providers and chart aduits on a regular basis to ensure compliance. Also, now all I do is coding and billing vs a Medical practice where I did clinical administrative and other tasks.
Administration needs to understand that sometimes coders need to take a little extra time to obtain additional medical records to ensure accurate coding. This extra attention to detail will benefit the practice in the long run.
The physicians choose the E/M code they think is accurate for that visit and then I go through all the charts and audit them and assign the ICD-9 codes and change the CPT if necessary.
I am the only person coding, posting charges, posting payments, doing follow up, appeals and collections in an ASC that serves 11 surgeons.
I have been promoted to the Corporate Trainer after obtaining my certification. Part of my responsibilities are to see that our coders stay in compliance and up to date with current coding issues. I no longer code on a day to day basis. I handle client coding and reimbursement audits when requested.
Our coders check all CPT and ICD9 codes provided by our physicians. Although physician coding doesn't always save the coders time, it does point us in the proper direction if we have problems understanding the documentation. Our physicians welcome coders' qustions and use this as a way to educate coders as to what the procedure may involve.
I work in a small 100 bed facility. I currently code outpatient services (DI,lab) and emergency room. We have one coder who is not certified who codes non-Medicare inpatient charts and then contract out all our same day surgery/and inpt/outpt Medicare charts. I'm expected to code and do ROI, as well as handle any phone coverage as needed when clerical staff is not available.
I work in a business that basically does coding for EDs. It did not require certification or experience but you did have to pass tests and then proceed with an intense 14-week in-house training program. I appreciate not having to have experience because most places require at least one year. Pay is not up there with regular coders and though accuracy is stressed--productivity (30-33 ED charts per hour--regardless of their level of difficulty)is stressed more.
I am the only CPC in our office. I work for a clinic that is hospital owned. I spend more time doing clerical/data entry.
I'd like to see more classes offered for Workers' Compensation Coding.
I work for the insurance company and ICD-9 and CPT coding is very important the the area I work. I know if the provider's office is giving us the correct information and able to help them out when possible.
Not working in the medical field at the moment
I am not challenged as much as I would like to be in my current full-time position, however I do enjoy coding.
I am working as a Refund Specialist. I am a CPC-A & review EOBs and patient accounts and decide who gets refunded if there is a credit balance or research why there is a credit balance on accounts. I review contracts and make sure insurance companies are paying the codes according to the fee schedules/contracts.I will have the opportunity to do some coding in the future, once I have totally learned my job and am comfortable. We are encouraged to have 2nd & 3rd occupations.
The AAPC needs to meet with insurance companies to implement a policy that all medical offices need a certified coder in order to provide accurate coding and billing.
Work for Medicare HMO. Teach physicians ICD9 coding and documentation.
I work in billing office for clinical laboratory so we code the dx's we are given from the doctors office. A lot of my work is calling to get dx's that were not given to the lab and /or faxing requests to get dx's. Also a lot of it is making sure these codes are medical necessity for the tests and if not calling doctor's office to make sure they dont have any other dx's that were not given on the lab order
We are in the process of implementing an education program to help the doctors code their E/M visits accurately. Some are more eager to learn than others, but I have every reason to believe that soon my answers to does doctor coding reflect compliance and increase reimbursement will be agreements instead of disagreements. It's a learning curve though and we're working on it.
Must always be current in multiple specialties. It pays to be very organized in order to keep up with particular desires and billing requirements of each physician office and specialty. Resources are helpful for coding but ultimately, the payers always have the last word.
Compliance auditing, appeals.
We are a teaching facility and we do our chart audits and do have discussions with the docs after we abstract their charts.
I work in administration. I am one of six coders for 40 out patient clinics.
Our office specializes in therapy/rehab. The majority of our patients have back and neck injuries due to motor vehicle accidents and work related injuries. We also do a great deal of hospital consults and daily visits to our patients who have been admitted.
I love coding but the 5 hour test just does not give you enought time to take. And if you pass part you should not have to take the whole thing over, just the part you missed
Our physicians, are going to electronic health records and the software helps them to choose the correct E/M coding and diagnosis
I am still working on getting my coding certification, therefore, my answers are not to detailed.
Having your coding certification helps with making decisions on certain types of appeals we receive in our office.
The extent that physicians do their coding involves writing their ICD-9 on encounter form and selecting services performed on superbill. The account manager/coders are expected to review for accuracy and correct as needed to meet compliance rules
I am currently the Office Manager; our office has EMR and the physicians rely heavily on that, though as a coder, I find the EMR lacking in certain areas and have informed both the software company and the physicians. I have audited notes and have given the physicians info how to determine E&M levels and the importance of correct and complete documentation.
As a consultant I audit charts that have already been coded
I was hired as an assistant to a lead auditor. Currently, I am verifying insurance benefits in a different office within the company.
Coding is very good job because not only for earning but also we can improve our knowledge every day...
I work for three cardiothoracic physicians and only two of the three physicians do any of the coding and then it is just CPT. I have to check all of their codes to make sure they are right. They have no idea about the use of modifiers. If I have to ask one of the three to redo an op note they act like I do not know what I have asked them to do. But when the denials come, documentation not being right is a problem -- my problem.
I'm a coding consultant and my job is to educate the clinicians. We do monthly audits to establish level of education needed. We also do grievances and compliance issues.
unable to complete survey due to not currently working while in school.
I would like to comment regarding the number of CEU credits required by AAPC. 24 credits a year seems like a lot especially when they are not AAPC approved and only l/2 of the credits are given i.e. AHIMA. I would really appreciate your review of this area.
I do surgery authorizations. So I am coding before OP report is in. My codes are not always the ones used in billing. I am not part of the coding department although coding is a large part of my job. We have billing reps for the different insurance companies they are the ones who handle the appeals some are credentialed but most are not.
Most important aspect of coding for DME is HCPCS. Drs are asked to provide Dx codes in the ICD9 format. Only when they don't does company have to look up. Also, often Dx listed in progress notes don't show up on form where Drs were asked to fill Dx in ICD9 format.
My work area is extremely different from that of the outside arena. I code for a military treatment facility.
My main job is insurance referrals to specialists that we refer our patients to, and prior authorizations for tests ordered for our patients. I share the responsibility of coding/auditing our fee tickets with another biller/coder in my office. I share an office with one of our providers who is very helpful about sharing his knowledge with me regarding tests etc.
There are never any neurosurgery classes or anything for CEUs in the Nebraska area. Most of your online classes don't include Neurosurgery, only orthopedic.
I can't stress enough that there has to be an open line of communication between the provider and the coder to help assure that both are equal in compliance with coding and feel comfortable in going to one another to help address any coding issues that may arise.
My work environment is not that of an active practice. My company sold our practice and went into Pain Management Consulting for other physicians so I have to stay on top of all changes that effect our company to keep all my physician clients compliant from coding, billing, documentation and reimbursements. I love my job and the changes that we as coders have to stay on top of each year.
I am a owner/consultant of a education and consulting company that works with physicians and thier staff all over the country.
I would like to see more specialty training for physicians and coders
Our physicians and other providers are the only ones who can change codes. The CPC can recommend and request codes left off forms, but the providers must change only.
Enjoy the coding, discouraged by babysitting clients for clarity.
My work is auditing physician medical record documentation and coding education for the physicians and coders. Our organization has one hospital and many outpatient clinics with over 450 physicians.
I work for a large rural hospital, performing concurrent E&M coding, providing feedback/education to our doctors, and auditing notes to ensure the highest level of quality documentation.
Though I have my CPC, I am employed and paid as an insurance clerk. The way that charges are marked, entered, and posted, the insurance department basically deals with the claims at the end of the process. The physician marks the charge sheet, the cashier enters the charge/diagnosis codes, and the bookkeeper then posts the transactions. During the filing process we deal with errors that edit out in a report or get the rejected claim. Coding skills are used to update the chargemaster.
I'm the manager of a multi specialty billing office with 4 cpc billers, 1 non cpc biller and a cashier.
I work in a multi-specialty medical clinic and most of our dr's do their own ICD-9 coding. I code for the ED department and the dr's do their CPT coding but I do the ICD-9 coding.
I work for a general surgeon. He is the only physician and we have two NPs. I am certified in coding and he takes courses annually on coding. I am the office manager, receptionist, coder, biller, etc.
We are multi-tasked from verifing registration accuracy to reading op notes/dictation and coding to data entry, claim submission to payment posting, then working denials and appeals which includes work comp Intervention to Filing Medical request for low payments, also patient self-pay arrangments, collections and insurance aging.
I work for with the DoD. These physicians are not reimbursement driven.
I work in workers comp at an insurance company
I do not work in a physician office or hospital. I consult with a group of practices and hospitals, so many of the questions in this survey were not applicable.
As we have multiple physicians with different levels of coding experience, my answers are based on the average of all. I have a doctor that has NO interest in coding and it takes assistance from myself & our compliance officer to obtain compliance. I have another doctor that dictates with CPT language, clearly describes extra work, and is almost always correct with E&M code selection. Most of the remaining docs fall somewhere right between, mostly near proper coding & documentation guidelines. If there are documentation discrepancies, I am able to directly contact the physician & documentation is properly updated and verified.
I code radiology, try to keep supervisors up to date on new codes when they will listen. We only have two coders including myself for 200+ doctors and sites all over the US. I have a supervisor that thinks she is a coder. She needs to go pass the test and get certified! One thing I do not like about my work enviroment is my supervisor tries to make me code from signs and symtoms when I do not have notes from the Doctor. I feel that is fraudulent coding. She does not care she justs wants the claim sent out NOW! This goes against everything that I was taught.
I have been in nursing school for the last three years and a coder for eight. I hope to incorporate the two specialties in the near future.
I am a consultant. I answered questions from the perspective of the many clients physician offices that I support.
My training has been on the job. My employer has been very supportive of that. I have also taken an online program which I completed with very good scores, and attended a CPC boot camp. I have taken the test once and failed. I'm currently scheduled to retake in May. I am a very detail oriented person and love coding. Wish me luck!
I no longer work in a "classic" coding environment. What I would like to tell coders is that there are many different directions coding credentials and experience can take you. It's a wide open field with opportunities in many areas related to coding, compliance, education, and management. The sky is the limit!
I am the only certified coder in the practice. The manager of AR has taken coding classes, but has yet to pass the exam.
I wish that I could receive feedback from by coding, how do you know if you are on the right path. If in fact what your coding yourself is accurate. I work in a teaching physcian environment, where there is a variety of specialties, and it's easier to educate on how to document then it is when you're applying the coding rules in an auditing situation. It's tough when you have a variety of specialties, there's so much more research involved and you don't see the same diagnosis over and over again.
EMR will be implemented in our office in the coming months. Wondering how other coders have seen this change impact their work. What are new avenues for developing coder value to a practice with EMR in place? EMR is here, but no one is talking about how it affects coding!
I am the administrator and the coding manager. I am the only ceritifed coder in my office
Coding experence is an enhancement to my role as VP/Director of the Finance Department. Looking forward to obtaining other certifications as it relates to my role.
I am new to this job. I am practice manager and the only coder. I am certified. This is one of the reasons I was hired. New clinic with billing to be done on site. That will be me. The physicians are knowledgeable in coding. The CEO and Director of Operations know very little about the coding, billing aspect. Again, that is why I am here.
OF the six providers in this office, we have two that are usually correct in their coding. We have two that are almost never correct and two that are frequently correct, but not always. We have one charge poster for office and one for hospital, neither of whom is a certified coder. We do about half "prepost" review for accuracy. The remaining half we get on the back end, after insurance processes the claims.
I work for Banner Health Corp. Compliance is handled through another dept. I am a very small part of a very large corporation, therefore, our group feels that we are insignificant. Importance seems to be placed on the group which brings in most money, i.e Ortho, surgery etc. We are a very small FP group. Doctors are salaried and I feel that that fact alone diminishes their responsibility toward a) coding correctly, b)number of pts that are seen in a day. We are rebuilding after many docs left due to re-structuring.
I am the only coder in our office. I am also responsible for all receivable duties as well as other minor duties in the office. We also provide help to our senior citizens with insurance issues they are having. The office is located in a rural mountain community and we are the only health care facility in a 50 mile radius.
The function that I provide as a consultant is performing audits of the selection of code(s) as well as their documentation. I meet with the provider(s) to provide them with continued education and to assist them with any and all questions that they might have regarding changes within the industry.
We have 3 providers in our practice and I am the only certified coder. We have one person who does all the EOB postings and I do everything else. We are short handed but can't get the physician to realize this.
I provide my providers with the information that they need to be in compliance. They tend to stray from the guidelines about a month after I have given them coding information. The biggest problem being E&M coding which they do themselves. I am one of the main people in my office of 4 doctors that answers the phone and I do all the demographics and surgical coding alone. I do all corrections and help with appeals and am underpaid according to the average coders salary. I also live in one of the most expensive areas on the East Coast. I have been in my position with this practice for 20 years.
I work for a payer.
I am a self employed medical consultant that teaches coding and compliance, has a medical billing company and is the compliance officer for many of my clients throughout the country so my information is diversified and best describes the majority I come in contact with.
Work as an independent contractor to audit codes in outpatient settings. Majority of work is auditing E/M services. I like the flexibility of completing an assignment with one company and being able to take time off before taking on another assignment with a new company. Paid $25 per hour with no benefits.
Can Certified Fraud Examiner be a good addition to my current credential of CPC if I am serving my employer from investigation point of view to recover overpayments?
I work for a payer so medical bill review is my primary duty. Coding duties include but are not limited to coding any miscellaneous codes billed by providers, be mindful of fraudulent billings, CCI edits, & appeals & still be compliant with our State fee schedules, rules & statutes.
This is a new position for me. Some of my answers could change fairly soon.
I do A/R mostly, even though I am the only CPC in the office. The coding is done by the office manager, most of the time, unless the physician tells her to code something differently.
I wish the local chapters had more outreach activities and more public announced speaker events held on a regular basis.
I just started this position. I answered N/A to questions I was not sure of the work process.
In my work, they prefer that RNs review medical and clinical documents than coders
I am scheduled to take my cpc-h test in July 2008
I audit ICD-9 codes for HCC for a large IPA
I enjoy coding and wish I could work either as a traveling or home coder. I find there are too many distractions in the Medical Record department when you have a mix of coders/processors/transcriptionists. Unfortunately in hospitals, and no doubt other medical departments, there are seasoned employees who are no longer as dedicated to their job as they once were, and you have the rest of us who are willing to get the job done no matter what it takes. This split in work ethics causes resentment amongst the two types of employees which can make for some very frustration days. Our hospital recently began having coders work every third Sat or Sun. This was not welcomed by my fellow coders at all. I do not have a problem working weekends, however there were a lot of tears and upset people for the past two months because they didn't want to give up any of their weekends. It has been a tense situation and not a pleasant one to walk into every day. I take solace in the fact that I am currently training in Inpatient charts, which I love, and perhaps my situation will change down the road.
In my work environment, we need someone or more than one person to be able to stay current on all aspects of coding (CPT and ICD-9, Medicare, etc). We as coders do not have the time to research things and we get denials. Wish we had more time to get together as coders to bounce things off of each other.
I am a practice administrator for a family practice, this is new position I can see the need for certified coders in this practice. My previous positions I did not the see the need. The other item that always has frustrated me with CPCs is that someone who is not certified can be a better coder. I recently was talking to a two CPCs on preops for family practice. Here is their thoughts that we always code a physical and a consult if the pt has not had a physical in the last year. Gag, choke, whattttt? But my doc believed this until I showed him the rules and the fact the OIG is looking at this issue this year. That corrected his misdirection. So unfortunatly just because you can code does not make it right but a lot of CPCs think so. The other item that the AAPC needs to consider is that there are a lot of programs out there that are coding now.
I do the coding for home health
I work at a military facility where providers document on an electric medical record and code from the same system. The coding portion is frustrating to the providers to use so they usually pick whatever the computer assigns to the encounter or whatever they find that is close to what they were looking for. Coders spend the majority of their day verifying the coding on billable encounters, auditing and hands on training with providers.
Working in a military treatment facility is very different than working in the civilian world. Coding of encounters is not necessarily done for reimbursement, although our facility brings in a good bit of money from claims. Coding is also used to show productivity of the providers. Their productivity is determined by the total number of physician workload RVUs that they generate. Providers do their own coding in our electronic medical record. The coder's main responsibility is to review billable encounters that are found in the Coding Compliance Editor (CCE) that coders use. Auditors audit the provider documentation in the electronic record and provide feedback to help them improve their documentation. The pay of the providers is not dependent on their coding. Being military their paycheck is always the same. This makes it difficult at times to do coding training and education because they are not effected monetarily by any changes that are suggested.
When charges are being billed by people who don't know a lot about coding there seem to be a lot more unnecessary denial. I feel education is very important in a billing office we should be able to have the support in a billing office to educate every person involved in the billing process in order to obtain full reimbursement without denial.
I'm a consultant so my environment is a little different.
We are expected to "translate" medical verbiage from medical records or lab requisition into codes. Our office does not use the term coder or coding even though that is what we are required to do. We do have a few certified coders or those that have previously been coders but they are not in the part of the department that does the "translating."
I review medical bills for payment processing. We have our HIM dept staffed with RNs, RHITs.
I work for a payer as a provider educator. Basically, if claims come in coded or billed wrong, I educate them on the right way to bill.
I am employed as the office manager/CPC. There is an additional CPC in-office. We use electronic medical records, so the physicians use a pick-list for CPT and ICD9 codes from the templates designed by the physicians and myself.
I would like providers/ billing offices to understand the importance of correct coding/compliance/accuracy of the initial claims being submitted to the payors rather than seeing the emphasize on quick submission.
My providers have a pick-list available for CPT and ICD-9 codes, but they also select from the coding manuals. My providers (including nurses) select CPT codes. My E&M audits recommend the level of visit, but the provider always has the final decision.
I am the practice manager of a 2 man surgical practice. I do not know the amount of training the doctors receive concerning coding, I am sure there is some. The other biller and myself will submit bills that appear accurate according to the DX they write and the follow up indicated, if the E/M appears to high, we will review the progress notes before the claim is billed.
As a health insurance payor, my employer has numerous certified coders to help watch the hcfa/ub billings. It is surprising to see how many practices mis-bill services regularly.
I travel the country 3 weeks of every month as an Application Specialist, providing training on Medical Coding software from my company.
Many coders work in consulting firms and woth attorneys, performing audits as part of an IRO, providing education and audits for hospitals, clinics and physician practices. They also provide expert testimony for Medical hearings. Part of my duties also include working with accounting firms to review the coding and billing practices when physicians are purchasing practices. This survey did not capture any of the duties of a coder in a consulting firm.
Wish there was a website to get feedback on coding questions
I have had as many as 75 coders under my charge in multiple location sites, auditing, mentoring, and supervising their coding efforts and more. My work varies from assignment to assignment.
I have not been able to find a job as a coder since I passed the certification exam. I work as a Rehab Tech in a Skilled Nursing Home. I am trying to find a job as a coder.
It would be nice if there was more consistancy between payor rules. My work environment encourages continual education and provides the tools to keep current with all payor updates.
I currently work for a medical group . It is a small but going group. I am a Risk Management Coordinator for HCC. We audit doctor's files for HCC diagnosis and make sure they are reported for maximum Medicare reimbursement on each patient. We report our findings to the doctors and create a "problem list" for each file we audit to let the doctor know about our findings. The Doctors are encouraged to bring the the patients in for full assesment each year to benefit the patients health by keeping in touch and also be sure that all diagnosis are reported acurately each year.
My family owns the billing company we work for. There are 3 of us working there. All are certified coders.
Not enough importance is given to the certified coder. It is assumed that anyone in the business over two years can do the same level of performance and accuracy. I totally disagree. If you do not keep up with the changes that occur every year, your practice is absolutely in jeopardy!!!!
I supervise 24 coders and auditors, train physicians, nurses, NP, PA etc how to document and how to code correctly. We audit 100% of our billable cases but most of our patients are active duty.
Neurosurgery coding classes in the Omaha, Ne area, PLEASE!!!
I work for an insurance company. Most of what we do is educate provider's offices on correct coding, assisting them with online resources to assist them with submitting clean claims. On occasion, we are called upon by various departments (ie Provider Relations, Appeals & Grievance, Healthcare Services, Medical Review, Claims, and Customer Service) to help them research guidelines for coding and use of modifiers. I also work on a couple of committees that set up the new codes for benefit programming; research E & I procedures, tests, etc. Many times specialty offices will provide us with documentation and websites for additional information to assist us when auditing claims.
Other duties include: compliance education/research, OCE processing, etc.
In our military facility, the providers are doing the coding using a templete in the electronic medical record system that we have.It is very time consuming due to all the documentation needed to get high RVUs. I do random audits on each provider and I do regular training either in groups or individual as needed.
I am a supervisor, and I am in the process of becoming a certified coder. I took and failed the test, and I will now begin to study for my retake in the Spring/Summer. We have an electronic medical records and billing system that can suggest the level of coding for the providers, however, most of them are very accurate with their knowledge.
The main problem i have found over the years as a coder and nurse is that we are undervalued by the physicians, so MDs think anyone can code. Others value our opinion but in general they still don't see the bottom line that we are very important to making a practice successful and we are not paid enough for our valuable knowledge and expertise. Continuing education is important and coding help in the means of paying for an outside service for questions and audits are important.
I have a 50/50 split with providers. 2 NP, who want to know more, & appreciate coding assistance. 2 docs (older) shake their heads yes but still do not comply. Uphill battle. I am the manager and only coder. I review the work of the girls under me and trained them. I have to handle contract negotiations, manager the office for charges at RHC but not payment, appeals, etc. Done by hospital. But I do the docs' personal billing for ER, outpatient services, and hospital stays. Some of your questions were hard to answer based on what I do. The RHC world is very different and I have to balance between both worlds for compliance and coding issues.
This survey did not really reflect the home care environment. There are no physicians in the office and therefore most of this survey is not applicable. We also do not have certified coders leaving the caregivers responsible for the coding. We have coding seminars and I serve as a resource for their questions.
Physician documentation education is extremely important and must be ongoing. Keeping abreast of current coding info for coders as well as physicians. Random internal audits are extremely helpful.
I am the only certified coder in our office. We have a staff of seven billers. Our office bills and codes for several hospital employed physicians consisting of Cardiovascular Surgeons, Neuro Surgeons, Pediatric hospitalists, Orthopedics Physician Assistants, Weight Management Physicians, one Cardiologist and several other Mid Level Providers.
My job consists of check and check out duties including coding ICD9 dx codes for services rendered and inputting charges at the checkout electronically. Handling the phone scheduling patients appts and also spending time on the phone with insurance companies to verify eligibility. Pulling charts, printing fee slips and correcting demographics/insurance when patients come in with changes. Dealing with patients face to face ranging from prescription requests to making appts and corresponding to doctors the patients needs.
I am the only coder in my office. We outsource ER physician coding. I believe that employers are not willing for coders to spend enough time to research a code effectively. I usually spend time of my own learning. A billing company just wants to bill the standard codes to receive faster reimbursements.
In general, I think that the physicians doing their own coding is a good idea. But my office is inconsistent with chart audits, educating the physicians, and compliance.
I work at an insurance company dealing mostly with reviewing notes from physicians' offices and determining if they support what is being billed. I am also involved in the appeals process and audits. The coding team is divided by our areas of expertise.
I am also CCP and CMBS certified (that is also what I teach at CIDMA). I am working on my NR-CAHA and CCS certifications in order to expand my own credentials as well as teach a course at CIDMA regarding more hospital billing vs. physician coding and billing.
I work in a military treatment facility as the task leader/auditor. Coding in the DOD has some more guidelines to follow that pertain more to military personal. We only code for statistical purposes and to follow certain diagnosis for Public Health. There are a few claims that we do process through our 3rd party collections. I will say that coding for the DOD is much different than coding on the outside as I previously coded for an SNF and an ED.
I am fairly new and I have not purchased any CEUs at this time.
My practice codes for 2 hospitals wherein the physicians are contracted. We do no independent imaging. The manager makes an effort to comply so the practice will not get audited, but there have been no independent internal audits for the past 5 years. There is no program designed to educate the personnel in the office about any medicare/medicaid guidelines. I am the only coder. They rely entirely on me, and I have no time to do anything except code! Really, in my practice, its only about earning money, and doing it legally.
I code for IM, Pediatrics, Endocrinology, Pulmonary, Acute Care Hospital Charges, and miscellaneous other charges. For the most part I do have some very knowledgable physicians who listen to the coding guidelines and love feedback and follow what you tell them they need to do to follow the rules for seeing and complying with the guidelines of billing E/M services. I review about 300 or more notes per day for correct coding issues and send back to the physicians any wrong documentation and coding errors for there correction before billing if done by the provider.
I do mostly coding of inpatient visits by the physicians and then charge entry. Very little of my work involves filing claims and reviewing EOBs as that is done at a different location by a different company for our practice.
Doctors in my practice mark OV levels and at times asked to make a choice of dx from a cheat sheet for tests sent back with dictation and fee ticket.
I work in a pleasant environment in the medical records department with other coders in a small hospital in my hometown. I primarily code the ER physicians and analyze IP and OP charts. Sometimes I get my feet wet coding some OP charts hospital side.
My employer and his 3 extenders are very knowledgeable about coding. We meet monthly to discuss issues and I have a very positive enviorment where we work fairly well together. We do have EMR, so there are codes easily picked from a list but they are correct. If I see something that I question, a email goes to the provider and an answer will come back before services are billed. I also work as a consultant for a short time in helping a small practice get their billing in order. I enjoy taking information to them and helping them to better manage their office.
I do the data entry of charges. The OM post the checks. I do all the reviews on wrong payments, etc. I file all claims emc or paper. It makes it hard to send all claims in, do reviews; but, not be able to post checks to see what has been paid on the reviews.
Using dark shaded areas on the questionaire makes it difficult- to impossible to read those questions on my monitor.
I thought it the survey was interesting in that it did not capture coders who work for health plans. Coders have become increasingly important as health plans are being audited by the government and payment of Medicare patients is based on risk scores which are determined by physician coding.
I have coding issues with the new da Vinci surgery as most people bill with modifier 22 and others tell me as unlisted. It is a challenge with different payers as they won't pay for robotic surgery.
I do all the coding in my clinic. The office manager is interested only in getting claims out fast, my educating the providers and keeping her up on problems. Works fine for me!
I work for a Part B Medicare insurance carrier....
I review all charts and coding by a group of pediatricians for accuracy and compliance.
I think that some classes should be done on how to teach our dr's about coding
I my clinical setting I am the only CPC and review all charts and superbills prior to doing the billing. The posters have a responsibility to post correctly which reduces the amount of time I spend on reviews.
None at this time
I am not employed as a coder, this is additional credentials that assist me with my job. I assist our corporate coder, but my primary responsibility is as a project consultant
Besides coding and entering all surgery and hospital admission charges, updating and being the resource for all coding questions, I am also a co-manager of the office and coordinate the scheduling of all surgery and any paperwork that goes along with that process.
As an independent consultant I have the ability to chose my clients. I have found that I need to explain my clients how coding and compliance fits into their practice and why. Educating them has lead them to value my services more.
Currently, I am not a coder. I am a payment poster.
Training on coding issues, audit charts, review contracts with carries, and handle appeals for any denials. Help with company polices on coding issues. Review and help update computer system regarding billing and claims filing.
I am a student finishing a coding program, waiting to sit for the CPC test.
The questions were not very pertinent to insurance companies.
I am the coding/billing manager for a large group of surgeons. Our Administrator does not understand this business and because the physicians are always complimenting me on my work and the changes for the better I have made, she is jealous and doesn't support me. They ask her to order anything I need and she plays stupid and won't so everything comes out of my pocket.
It would make it easier to have the charts available to the coders when they need to be reviewed for possible coding issues. The group consists of 8 outer offices spread through the state and the administrative office which includes the billing and coding departments are centralized. They have been working on Electronic Medical Records but it has had its share of problems. And for now has been put on hold.
Since I am a certified coder and was hired to do billing, I would appreciate not being pulled into situations where I have to do other duties such as answering the phone, pulling or looking for charts for the next days surgeries,and having to do other duties that do not involve coding or billing. I don't feel I can adequately concentrate on my work and I feel it is slowly slipping out of my control. I use to have a good handle on my age report, but now I have no time to work on that aspect of my job.
Answered questions as to how providers' offices within IPA handle the coding aspects in general. The questions were geared towards a single practice rather than towards multiple practices encountered within an IPA. I provide coding education to the multiple practices as well as assist with questions regarding appeals.
This is my first week on the job. I'm still learning the ropes.
Overall the work I do is interesting, however sometimes I do wish I had more resources to back up some of my coding questions. I am going to try to get more involved with the AAPC website and see what resources are out there. Currently I do have a perplexing coding question that I have addressed to AHIMA's communities of practice. Sometimes Ithink more physician input or awareness would also help.
I have just starting working as an extern for a small practice 8 physicians. I cannot answer this survey at this time.
I am in a third party company which reviews documentation for CARA risk adjustment and compliance. This involves translating ICD-9 codes into Hierarchal Condition Categories developed by CMS. The coders at this company also spend a lot of time explaining coding to nurses, and other coworkers with less training and experience in coding which codes need to be assigned in the first place, and why. It is both frustrating and rewarding at times.
I work for the government and we have an EMR. The providers select their CPT and ICD-9 codes for each encounter. There are two coding auditors to audit the encounters. We also provider the education and training of all our providers on coding and compliance.
I am in a unique situation. I work a orthopedic surgeon. There are the two of us in the office. He is very hands on and we work well together. Getting out of the office for any reason is very difficult. CEUs are a challenge. I have always written operative reports for my CEUs in the past. It will no longer be accepted so I will have to spend money now to keep certification current. I am not that happy about this new situation. If you have any suggestions I would be most appreciative.
Coding for DXA and infusions are done by the Billing Manager/CPC. Providers do use a cheat sheet for ICD-9 coding, but they have been made hyper aware that they should code to the highest level of specificity. There is ample room for write-in diagnoses, which are then coded by the Billing Manager/CPC who will review the ICD-9 descriptions with the providers if there are any questions, i.e, 5th digit, etc. In my position, I also credential, contract, and negotiate fee schedules for the practice, as well as supervise my staff. Another important aspect of my position is to keep informed of copay assistance offered by pharmaceutical companies for injectables and infusion drugs, and private funds available for the same. Most forms for these assistance programs do require some coding. It is also important for the coder to have a good relationship with Business Account Managers from pharmaceutical companies when coding for new injectable/infusion drugs. Thanks for the opportunity to respond.
I work for a small family practice of 5 providers, 2 of which are DOs, 1 MD, 1 PA and 1 NP. Our billing dept consists of 4 including me. I'm the only CPC. I'm also the billing manager, so I have to do it all, the others experience varies from none to some. We use a EMR system that the Dr.s use to pick there codes. I don't have time to check every single claim, but do review many that require some changes.
I multi task as many coders do in an office setting.
I work for the VA Medical Center.
I am a supervisor who codes, manages the office, set ups the surgery, does the payroll. I do various assignments. I do not deal with reimbursements. That is done with another department
I'm a fraud and abuse analyst/investigator for an insurance company.
My work is as Fraud and Abuse analyst.
I work for a company where the coders are paid per chart coded, sometimes the coders that have data or charge entry experience will perform those duties. Not all of our coders are certified out of 7 current coders 4 of us are certified, which the only thing it means to our company, is it says they have certified coders on staff, as far as pay goes there is a difference. WE never see any denials, we have no communication with insurance carriers about denials or anything.
Our office only does coding and data entry. Our home office does the actual billing out and collection of reimbursements. We don't see the claims after data entry unless there is a problem with the claim, and it comes back to us for research/correction. This gives us a disadvantage of dealing directly with the insurers which would in turn give us a better knowledge of specific insurance nuances that could be avoided during initial coding/entry. We are able to research policies of the primary carriers, but we do that on our own and do not have good leadership from our home office that leads us in this effort. We are the only Emergency Department using this system, so we are rather on our own, and learn by our own resources rather than by company leadership.
I am the reimbursement specialist I do the audits, peer reviews and coding trainig of the new clinicians that are hired. Work with the established clinicians on coding and compliance in the office
I am the Education Specialist for the E. Orange VA and we educate and audite the staff at least twice monthly.
I work in a smal practice with 1 provider.
I work in a phys. office The providers fill out encounter forms. I code mostley dx. codes. They are still responsible for filling them out. I have a small office where it is quite and able to work. I do take patient phone calls.work denials and I have a very close relationships with the nurses that will help with coding questions that may arise when the phys. are not there.I do some cpt coding so i try to keep myself updated as much as possible. right now i am the only certified coder in our building. I am always willing to help the other ladies on their coding issues for the challenge.
We have a small practice with three physicians and three physicians assistants. We have three full time office staff and one part time medical assistant that is here for clinics and prepares charts for the next days patients. Because of our small size we often have overlapping duties. I have been with this practice for 11+ years and enjoy the diversity
I work full time a well as part time as a certified coder. The full time employer support the need for CEUs where the part time employer does not, but expects to have all the most up todate information.
I am an office manager of a 1 physician office. There is only me and another girl who works the front desk. I have trained her to do PAs and that helps a lot.
Our providres only do E/M coding!
Payor environment, would like to see more marekting to payors about coding as well as support materials and promotion of coding in the payor world.
I worked for 3 yrs as a certified cardiology coder and now make more money doing reviews and posting office tickets, which I am now bored with doing. Finding a challenging position as a certified coder is becoming more difficult, as our area seems to be "flooded" with CPCs and not enough openings.
The office I am in does office billing by one group of people and hospital services by another. It has never had a coder certified or not. We are starting to build a program and are deciding how we can utilize coders in the best way. Right now I am the only certified coder.
I am the only coder for 14 doctors and sometimes it is a little overwhelming
I am the only certified coder. We have two other very capable noncertified coders. We have on average 19,000 visits per year. We are owned and operated by an Indian tribe, and it is more than 60 miles to the nearest hospital. We provide clinic appointments, advanced access, urgent care, walk in, lab and x-ray services, specialty clinics, and dnetal services.
I'm a physician educator and auditor. I audit physician coding and documentation and give feedback and education on the results
My physicians have a pretty good understanding of coding which makes my job easier. I mostly code the hospital rounding and op notes. The physician usually tells me the level of service performed and I have to audit the E/M at times.
I am the Coding Manager and think it is very important for the manager to be certified. My employer is very understanding with the need to keep certification current and provides us with all CEUs and all coding materials needed for the job.
My docs do the office visits. We, the coders, do endoscopy and hospital coding.
We are on a new health connect system where the doctors visits automatically drop in the system and we code from the visit, an E&M code is put in by the doctor but we verify it and change it when necessary and add all additional services rendered.
My title is Business Office Manager and I have less time to code than I would like. My duties run more toward management at this time. Our practice is growing and hopefully with more staff I can get into coding and appeals, etc more as we grow.
I honestly believe and I mean no disrespect but until coders hired are required to be certified, companies are not going to realize the value of the coder.
I am the business office manager. I mainly oversee the billing dept. (8 people). In addition, I perform quarterly audits, handle IT issues, negotiate with ins. companies and implement new services.
I work for an ob/gyn practice with 2 providers and a nurse practioner. I am the only certified coder and biller, I also schedule surgeries for each physicians and also handle accounts receivables. I wish there were more ob/gyn related workshops to attend.
Financial counselor who works with coding issues. I do not do audits.
I am the Manager for Coding, Reimbursement and Compliance for our IDTF and JV Cath Labs. We have 1 credentialed coder who reviews documentation and charges for our JV Cath Lab. She was hired right out of college with very little coding experience. We have another staff member who reviews the documentation, charges and billing for our IDTF facility. She has physician office experience. I am responsible for overseeing their duties, education and maintaining compliance standards for these facilities including physician education.
I work in a small office with a doctor and a physician assistant. We have just moved to an electronic medical record and this has temporarilly slowed down our coding and billing process and increased their responsibility for understanding coding requirements. At the moment I review 100% of all visits, documentation, and coding.
One of the most important keys to fewer denials and faster reimbursement is to file clean claims. The way I am able to master this is to review each charge slip before submitting the claim and make appropriate corrections. Any errors found are reviewed with that coder to educate why the error is incorrect to avoid future mistakes.
I am currently a Medical Review Analyst - I review all claims for coding errors as well as handle all appeals and corrected claims.
In healthcare consulting I am called on to review new approved medical devices or drugs assess existing coding systems and nomenclature available to report these items as well as codes for the diagnoses, and services and or procedures associated with their use. Recommendations are made on applciations and processes for requesting new ICD 9 codes, CPT codes or level II HCPCS codes as warranted. We also assist in identifying barriers to coverage or reimbursement by third party payers based on known payer coverage and reimbursement policies.
Since I am a healthcare consultant I only work with physicians not for them.
Our providers select the level of service performed, however if the documentation does not meet the requirements, the level is disputed and discussed with the provider, whether up-coded or down-coded. This is part of the education process for our providers.
I work in a teaching institutional environment. My providers think they know how to code from their documentation, I let them but my billing staff actually reads all of the notes and assigns the code based on the notes. Sometimes what the provider has does match. The providers use a pre populated fee slip on which the most popular diagnosis are but the providers leave out the detailed diagnosis and just check ones on the list.
My manager doesn't think you need to be certified in coding. I am the first at this office to be certified. It's still a new thing. Most doctors do an accurate E/M coding and we have a check system here to help prevent inaccurate CPT coding. We have a good working relationship with the doctors. We are readily able to discuss coding issues with them daily if need be. The are very knowlegable in coding.
I am not employed, this is my own business, so therefore, I pay all of my own expenses.
Physicians and practices are our client. We conduct audits and training for physicians and staff in regards to coding compliance.
I work in a public health womens reproductive health program closely linked with the state's Medicaid program. Few, or possibly none, of the staff responsible for managing codes for program benefits are certified coders. This is an area where AAPC might target outreach.
I work in a clinic where ther's a Part time staff doctor in the mornings and diffrent doctors that volunteer their afternoons. I'm the only coder, biller, RA specialist and the front desk supervisor!!!!
Ever Changing and Constantly Updating new procedures and processes.
I work as the Coding Supervisor for an entity that manages the A/R for the physician offices owned by this entity. We have mechanisms in place to review certain billing practices, claim denials etc as well as hands on coding for ED, Urgent Care and limited facility coding at present.
Our physicians generally leave the coding up to the coders, although some do try to code E/M for hospital visits. They do code the daily tickets and do a fairly good job at that.
I have 10+ GI Phy to two phy owned ASC's. I am Billing Manager which entails responsibility of 7 employees in the Billing Dept. I have one CPC Coder, 4 billers, 1 pmt poster, and one Collections person. Also meet full board with Phy on coding updates and/or at their request. Keep all system coding updated and Audits when needed also make sure we stay and are in compliance.
Need to know more info on how to access free on-line info of questions regarding correct coding procedures with instant feed back on questions.
I would like to see more affordable opportunities for Specialty Coding. Credentialling is very expensive, and the cost to be current is becoming even higher in the specialty realm.
I am a medical investigator-an auditor and reviewer of medical documentation and claims. I work with nurses and fraud investigators.
I am the Practice Administrator who is also a coder.
I am the office manager for a billing and collections department for a small private hospital
Currently I am the most experienced coder in practice. We bill for 9 physicians. Only one or two do their own coding. What they code and how we are re-imbursed differ greatly. Most want me to code out as much as possible. Trying to do coding audits to assist them in correctly coding out procedures.
I work for a managed care insurance co. I educate providers & their staff on coding & compliance. I conduct workshops annually & one-on-one if requested. I work some in the office and most of the time out in the field. My title for my job is a Clinical Provider Educational Consultant.
I do the surgery billing for 24 orthopaedic surgeons and 6 PAs. The doctors give the code to bill and I review and make any suggestions for improvement.
I am Chief of Emergency Medicine at our hospital. 70,000 ED visits. Physicians code own charts. Certified coder double check our work before it goes to our billing company.
I work referrals,disclosure tracking, medical records and front desk when needed.
Based on Salary Surveys ... It needs to be documented that as certified coders managers and non-managers based on the specific demographic areas salary ranges are not accurate and need to be reflected so that coders aren't misled to salary expectations w/wo experience. The practice needs seem to be standard in Upstate NY not what education and credentials, you, as a coder can bring to the table. Physicians need to be educated on salary expectations and the strengths coders can provide a practice with higher reimbursements.
I use to be responsible for just coding but when I changed companies I then became the top coder, reimbursement specialist, ambassador to an "India" company, main person for compliance issues, HIPAA specialists and many other roles as needed.
Work as a coding educator and consultant. Perform audits for medical practices, along with litigation support.
Moving to an EMR environment in the next months. Would be interested in knowing experience of other coders as to how their job functions evolved with EMR implementation. What new areas of expertise can a coder develop to enhance productivity and value to a medical practice?
I do not work in a physician office. My title is not Coder - however I hold a CPC. I work in a Medical Review of a Medicare Contract paying for Carrier claims.
I work for a payor. Every class I have attended sponsored by the AAPC is geared towards billers and it almost always seems that the payors are bashed. Lets have some classes for the payors! I hve worked for payors for 20 years now
Providers only code their evaluation & management services through use of our EMR. They do not code any procedures. Those are done by a CPC.
I am in home care and find minimal continuing education classes for ceu's in this field. Inservices offered by my employer are not always APPROVED by AAPC for whatever reason. Employer does NOT pay for continuing education and so it is a burden to find appropriate continuing ed. material at an affordable cost. I am a RN and must comply with that continuing ed., as well. Need to see much more offered and or accepted for home care. This is a growing industry and we need ongoing education WITH CEUs offered.
I bill for one practice and charge them a percent of my collections and all expenses associated with billing, electronics, pt billing, postage, resource books, etc.
I work in CDM Compliance not a traditional HIM coding environment.
I would say that there are times when the physician's coding is accurate, and does not need changed during the post-audit. Also, it is my understanding that physicians do have some coding knowledge that is taught to them in their med school time.
I am a full-time coder/consultant and I am employed by a Fortune 500 company. They match me with facilites in need of coders. I travel and code onsite, and perform whatever the assignment requires. My current position is contracting with a company that employs 1600 physicians across the country-I am working in the HIM department of the corporate office. This assignment gives me broad experience in so many specialties. The docs I work on have failed two previous inhouse audits. Because I contract I do not get pulled into some of the things in the questionnaire...however, that is also why I contract-I have been there.
I code billing tickets at my facility. The work is fairly simple and the level of coding is pretty basic. I also perform other duties which directly relate to my position such as; data entry, accounting for charges, and billing issues.
As a medicare contractor, a lot of the questions do not apply.
I am currently in the group health insurance industry, I am now seeking a position in billing and coding. I was recently laid off.
Poor clerical support. The three coders in our office are always delegated whatever duties the clerks don't want to to. Manager assigns it to the coders regardless of what it is because she knows the coders will do it and do it properly.
I manage 10 outpatient coders for OP hospital services for more than 30,000 accounts monthly
I am a Senior Compliance Analyst/Educator. I audit 500 providers for their CPT/ICD.9 coding. I educate providers on Teaching Physician Rules, Nurse Practitioner Guidelines, and E&M Guidelines.
I work in the Compliance Department and mainly work with a coding program that allows me to create coding/billing rules. These rules scrub the physicians bills and allows the biller/auditor to review and correct any errors the rules find before the claims go out the door. My job encompasses coding, auditing, compliance and IT duties.
I work as a same day coder in a hospital right now and some of the questions just don't pertain to what I do. I very rarely talk to the doctors or the offices to find out what codes or dx's are needed. I usually flag them in the doctors room and they fix it and I finish coding it.
We are a small office of 6 providers. They all do their own coding with 2 CPCs on staff that reviews and enters the data for billing. If codes/services are questionable-it is reviewed and discussed with the provider. There is good reception with the staff/porovider.
Data entry for ten doctors, charge corrections for 24 different co, request op notes from facilities, look over doctor calendars to make sure everything gets billed out
We code from the operative reports, we assign CPT and ICD-9 codes.
Love it. Coding for an REI.
The company that I work for provides education to all the physcians regarding billing and coding and has procedures in place for physician queries when codes may be questioned by the coder.
I am working on getting my CPC. The other two CPCs left!
I have been a coding auditor now for over a year. I have coded for almost 20 years and certified for 3 years. I work for a big company now where before I worked for a smaller, independent physician office. The difference is amazing. From pay to reimbursement of CEUs. The department for coders has become very big and diverse. The only thing I have had a challenge is coming from the billing side to the auditing side. When I did billing, I had the component of coding and appealing claims and understanding when things came back I could understand the payors side. We do not have this component where I work currently. We get nothing back. We have auditors who audit some of our work for accuracy purposes. I felt I learned and kept up with coding issues having worked in billing. Where I work now, we have coding department and billing is in totally different building.
I work as a Revenue Compliance Auditor in a facility setting, so my coding experience is necessary in reviewing claims for regulatory compliance in billing, documentation and coding. I audit both inpatient and outpatient services, ICD9, CPT, HCPCS and UB codes for accuracy and assist with denial management process for appeals. I also look at all new and potential procedures/services to ensure that charges and anything that is hardcoded on the chargemaster is set up correctly and compliantly and that education is performed for both facility employees and physicians providing services to our facility.
I am the only certified coder at my office. We are approx 70 FTE
I am the only coder at our facility which is a critical access hospital. I am also the Medical Records Director, Compliance Officer, HIPPA Coordinator, QI Coordinator and Medical Staff Secretary. I have three employees who perform the other HIM duties.
I am a clinical appeals nurse. I used to be in the reimbursement area of the insurance business. During that job, I received by certification in coding. With my current appeals job, I don't use coding as much because I am looking at clinical appeals denials and not coding appeals.
I am the only "coder" in the department. I do all the interventional/radiology codes for the busiest Cath Lab in Iowa. I have completed the ISP and will be taking my exam in March.
I am employed by the US Army and am coding in Heidelberg, Germany. The DoD does not code by the same guidelines as the AMA. And billing is somewhat relative but not really important. We manly code for the sake of data gathering and trending. I would really like to see a survey gather information about salaries.
I work for a health insurance company, so a lot of these questions did not pertain to me. I tried to answer as far as my job duties.
I am interested in getting specialized certifications.
I work in the insurance industry. My coding knowledge is helpful when researching provider questions or customer complaints.
I am the Practice Administrator at my clinic. I work in a multispecialty group, Our D.O. is a primary care provider and we also have a Nurse Practitioner, Chiropractic, Physical Therapy, Acupuncture, Massage, Infusion and Weight Loss. It would be helpful to start seeing more seminars and information relating to coding in a multispecialty group.
I know the coding starts with the providers and goes thru the change of command for accuracy. We do have training here for the providers.
I am a Fraud and Abuse Investigator for a large Insurance Company.
I work in a rural hospital where my "manager" is the ER director. She has no coding experience but plans to attend one day. I do all coding, auditing, QI, QA, and monthly/yearly STATS for our department. I code for the professional side as well as the facility.
Code Paps fulltime for an independent lab.
My job function is in managing the hospital chargemaster
I am not a coder in the traditional sense of the word. I focys on laboratory charge master, physician education, Medicare compliance, and assists on helping to rectify billing denials. I am credentialed as a CPC in order to provide a solid foundation for the tasks listed above.
In most cases the supervisors seem to be afraid to challenge the physicians when errors they have made are found. They would much rather keep quiet then adddress the situation.
My current job has nothing to do with coding. We have set codes that we use for home health services. I only need to reference these when getting benefit verification/authorization for services or working on claim denials.
More flexibility would be nice as well as getting paid for the amount of work that needs to be done
My responsibility also includes being the database coordinator for our practice. Plus sending all our electronic clms.
I work for a Medical Informatics company. Most of the work I do is either compliance related or pertains to specfic LCD updates. I don't bill/or code per se, I gather data from many carriers and fiscal intermediaries, that is compiled into our data set.
Since retiring from BCBS I have hired myself out to small physician practices (up to 5 doctors) and is most successful when more than one person is responsible for the multiple tasks associated with billing (Data Entry, A/R, collections and follow-up).
I work for a home care agency. Coding is really different from what I've learned in class. I would like to have more training/information in home health care coding.
Auditing claims for physician practices/ groups. I review for accuracy, and make suggestions when coding is inaccurate. I perform underpayment reviews and also appeals for denied claim.
I work in our Compliance department along with the Compliance Officer. I am a healthcare analyst and I audit charts (in both the office and hospital setting) for over 200 providers that include physicians, physician assistants and nurse practitioners. I also provided educational sessions on E&M documentation guidelines and teach chart auditing.
I answered these questions based on the last job I had which was working in the insurance industry.
No comments there, however, many comments about what the AAPC does for me. Possibly send out a survey on that subject.
I do doctors credentialing and managed care and check the bills for coding errors and compliance issues.
I have been in the Pathology Dept 40 years and do coding from on the job training. I took the certified coding test but did not pass. The majority of our coding is done by our pathologists. I only code the fall out of what they might miss.
I am a Coding Supervisor so this survey was difficult for me to answer so I did the best I could with my staff in mind. Also, the above questions regarding the provider involvement in coding is implying I would be working with one provider. Since this is not the case as I work with hundreds of providers, I answered them as agree if it was true for some of the providers.
I wourk in a tribal health dDepartment. They do not bill, hence they do not think that coding is of that much importance. I, on the other hand, am trying to show them that coding is just as important even tho we do not bill. Documentation is always an issue and the money I have to put out for furthering my education and keeping up with my CEUs is a real drain. I feel that coding from home would cut the burden on myself - that is not an option in this organization. I am one of the busiest people in this department, they do not realize the improtance of my position, they do not understand keeping up with all the state and government regulations takes a lot of time
Our medical directors - physicians at our insurance company -- are not certified coders. They do no code. We network with many national coding experts for difficult issues with our providers regarding coding and glad they are so helpful with our business. We appreciate them very much. We've met many of them through educational sessions where we get CEUs.
I am the supervisor of 7 clinic coders and 3 inpatient pro-fee coders.
My answers are based on the job I just left since I changed from medical to dental field. Thank you.
I work for the Veterans Affairs Medical Center as a Lead Coder; I supervise 3 outpatient/1 inpatient coder along with 2 release of information staff. I still do some specialty coding (Physical Medicine [therapy], Brace Clinic, Ambulance, Telehealth, etc..) I also do coding audits on the coders and documentation audits on the physicians. I do several specialty reports for the Chief of Staff. I am involved with our Compliance Committee, Medical Record Review Committee, and the Veterans Equitable Resource Allocation (VERA) Committee.
I am the practice manager and the coder/biller also
I work as a fraud and abuse investigator for a private payor.
Our hospital based clinic has 3 outside regional practices that we have to travel to and code for their radiation oncology departments as well as ours. Along with coding we also get insurance referrals and prior approvals before treatments, so we are a dual purpose department.
We are a multi-specialty billing company with clients in CT,NY,& NJ. We bill for private practices & hospital (professional component billing) I deal with compliance, audits & education for staff & providers.
We do charge review and charge posting. We work our outpatient claim edits also.
I do not code on a daily basis but use my coding knowledge to work denials and do appeals. I work for a billing company and are exposed to a wide variety of coding, pathology, surgery, family practice.
We do 100% auditing on all our E/Ms and procedures. It takes a lot of work and a lot of coders for our large practice (about 30 docs and NPs).
I enjoy coding for anesthesia and reviewing charts for compliance.
The 40% in question #1 represents only "performing data entry" for my department in the form of set up and maintenance of new/revised CPT, HCPCS and ICD-9 codes and pricing in our computer systems, as well as coordination with the finance department regarding code set-up for provider compensation. We have no other front desk or medical record duties.
I work as a medical auditor and while my coding experience is valuable, it is not required for this position.
I wear many other hats besides being the only certified coder in the office. I am an Administrative Assistant to the Manager, as well as handle our marketing, credentialing, contracting, and coding issues. We are an Oncology practice made up of 2 physicians. I wish there were more coding classes offered for Oncology/Hematology specific issues.
i manage coders and do very little coding myself. I am certified. My employer would prefer we obtain RCC certification.
I am the Administrator for a 3 provider OB/GYN office. I am the surgery coordinator for two of the providers and I write up the surgery packets, code and precert the surgeries, and enter the charges after recieving the operative reports. I am the only coder. I handle all of the office finances and payroll for 3 different corporations. Etc, Etc....
I do provider and ancillary staff coding training based on the result of the audits that I do.
Part of my job is training new providers of compliance and billng regulation.
I am a Unit Cordinator presently when I have completed my exam I will be certified. I work at a facility and hope to stay here and complete my career here thanks
The work we do are for provider clients hiring us to audit, improve receivables, manage appeals or get involved in legal issues related to fraud and/or abuse.
Compliance coding analyst for 200 physicians
I am self taught and try to attend a class each year along with coding books and self testing checks as often as possible.
Since I work in a payer company, the review of claims for accuracy is important. The coding is part of the review that we do for claims. The payment to the provider is based on correct coding.
I am seeing a high rising trend of physicians purchasing software that minimizes the use of coders i.e. PCs in the exam room where the Dr enters information at point of service and the software basically dictates the code outcome. Also an issue is that they are looking to coders more from an auditing source rather than actual sit down coding.
I am currently seeking my coding certificate. Hopefully I will become a coder soon
my practice uses an EMR for their coding
Coders are expected to enter demographic/insurance info for hospital patients. Very time consuming.
The physician code their E/M services using an encounter form. They write the diagnosis on the form and the staff uses our electronic medical record and/or coding books to find the appropriate code. We do not have coders in the dept with the exception of myself but this is not my role, I am the Business Manager and decided to get my cetification so that I could education myself, the staff and physicians on proper documentation, coding requirements, and to have a better understand of what exactly impacts the clinic revenue. I have found this to be extremely helpful.
As coding manager, I'm now removed from day-to-day production, and my coding involvement comes into play when helping our patient account reps work their coding denials, as well as performing periodic audits for our physician clients. I also answer physician questions re: coding scenarios.
I am currently managing the central billing department for the hospital off site clinics and speciality clinics. As the manager I oversee the billing, review of denials and appeals. With this I feel I should have more input into the provider education. I currently have to go through the managers who in turn speak to the providers.
I am a coding consultant and do not work in any one physician practice. I have multiple clients and provide a variety of services including auditing, coding support, education to physicians/providers and staff, and provide litigation support.
i am certified but i am a insurance follow-up lead and I direct things that need to go to coding so it can be changed centrally and educate the docs
I am a redetermination officer for Medicare. I have physician consultants (Carrier Medical Directors) that are very informed about coding.
Although most providers select codes for the surgical areas, we still review operative reports for accuracy and application of any approprate modifiers, providers also receive annual E&M eductational reviews to be sure that they maintian an approved accuracy ranking for selection of their E&M servcies.
My situation is that I'm married to the doctor so he hears about coding at work and at home!! He iS VERY Alice Marshall
As a traveling coder, I do not see many of the same views as I would if I were stationed at one job. Mostly I have been working for Hospitals and the Physicians surely could cooperate more with the HIM staff all around. Their documentation skills are sometimes horrible and they are offended when you query them about their documentation. They want the reimbursement in a timely fashion but it is hard to code a visit with bad documentation.
I've been with this practice for 8 yrs and the practice in finally appreciating the work that I do and it's importance, but we still have a way to go.
Billing Supervisor for Urology outpt clinic. Staff consists of billing coordinator, patient service representatives.
I was unable to respond to a number of the questions above as I do not work in a physician practice setting.
Previous job/s involved clerical, appeals, auditing, pulling medical records, data entry, speaking with staff and providers regarding compliance and billing, and policy development.
I work at an Insurance Company so a lot of the above questions did not apply to my position.
Most of the questions are not pertinent to my coding situation. Difficult to answer as I don't work for billing, nor in a doctors office.
I work for a health insurance company supervising nurses and coders doing medical review for reimbursement issues.
I code & bill out all the surgeries for my group (over 30 providers), I also bill out all hospital charges and deliveries for our high-risk Perinagologists. I review all denials if our Collections Dept has questions, train staff & physcian's on Coding, run various statistical reports for our Medical Director, help when we have issues with insurance companies, update our yearly fee schedule & maintain the CPT & Diagnosis codes in our system.
My job clarification: Medicare Medical Review nurse.
Employed in the Fraud/Special Investigations Unit. Review MD records for accurate coding/billing practices.
I am registered with the State of Washington as my own business. A/R Management. As of today I have one provider. I have been in business for myself since 03/01/2006. I meet someone to pick up work, for now, and I do the billing/coding only. I have them fax to me whatever I need, for now.
I review medical documentation and codes. Make payment recommendations
I am in a very rare situation in that only 18% of our revenue comes from private party insurances. It is much more difficult to "force" our physicians into seeing the absolute necessity of accurate coding and documentation since our funding is provided by the government. In addition, we do not have RVUs to measure workload and cost accounting, etc.
Providers code office-based services in my office, but do not code for hospital based services. Tthe coders do that.
I code for two physicians in our practice and one is good about marking charges with CPT and ICD-9 and the other is not.
Our practice has one lead coder which handles audits and physician education. All other coders including myself work on AR with the insurance company. We handle research for all denials and scrub the claims before submission.
Well I am the Pt Accounts Manager, a supervisor and the only CPC for a multi-speciality Neurology practice and have one other bill for 4 Dr.s & 3 NPP's. The MOST important part of great reimbursment is my software vendor-it has all of Medicare's "special" rules built in - so I will know right away if a claim will be accepted/and or what I need to do to fix it. My days in AR are at 30.9, which is down 45.9 a year ago. Plus eliminated 2 FTEs.
Coding done by our physicians (on a hospital card or on their PDA) is reviewed by a certfied coder before entering into the system that generates a claim, or through their PDA before the claim is released to generate a claim.
I work from home as both a sub-contracted coder and am also a full time employee of a billing company. Working from home and maintaining one and a half jobs has enabled me to gain more experience and make more money. I know few people my age who have excelled in a career without a college education like I've been able to as a CPC.
I work for a large health plan, we do post pay, pre pay reviews and quality checks, this includes clinical staff and professional coders. We validate the payments by reviewing the medical records and procedures dictated. We also use coders to identify fraud and abuse cases.
I do hospital based work. I answered on my knowledge of how things are handled here in PFS.
I work for a very large university-based physician practice. Some policies/procedures are therefore not controlled by our department alone. Also because we are so large & removed from the physicians we code for, we don't have much of a personal relationship with most of them. In fact, in the almost three years that I have been here, I think I think I have only met one of them, and that was because he initiated the meeting with coding in order to ask some questions & clarify some things. I feel that this is truly a disadvantage but hard to overcome when there are so many levels of red tape in a large institution.
Recently hired as a Coding Auditor II. Love doing the CPT and ICD-9 coding and preparing the codesheets for billing.
Quanity is important, but quality should be more important. Somehow this needs to be weighed out. To do the numbers that they want does not leave time to search the chart for as well for quality. Some image accounts take a long time to download and this takes away from the time we are allowed to code a chart. Example: we are allowed about 1 minute and a half per chart, sometimes it takes 30 to 45 seconds to download and that is half of your alloted time before you even get started. Image freezes up a lot which takes away from your time also. thanks for listening.
I work for a large pediatric multi-specialty hospital. Some of the departments embrace coding compliance and see the audits as educational. Other departments are uncooperative and do not feel that coding compliance applies to them. We work hard to try and establish a good working relationship with all our providers and to make education our main focus. We take a proactive approach to coding education instead of a reactive approach where the only time the providers see us is during a routine coding review or focused audit.
Our clinical staff does the coding. My day is spent reviewing the charges to make sure they are correct before the claims are released.
I am a coding specialist for a integrated health system billing office where we have over 200 physicians and the work that I do is very detailed and in tense because the practices do not have credentialed coders to review documentation and claims and the physicians are not coders either. Much education and audits are very much needed and we are very busy.
I am the chargemaster coordinator for a large hospital system consisting of several individual hospitals, a large health campus and multiple outpatient facilities. I am responsible for keeping codes current and education of each outpatient department regarding their use. In addition I am a resource person for patient financial services and am responsible for any invalid diagnosis code issues. Although I completed this survey it was not very pertinent to my job or hospital coding in general. More CPC-H related articles/seminars, etc would be helpful. Thanks
My employer has a great understanding of the importance of correct coding, billing, and compliance and is very supportive of continuing education. Having the option of flextime really increasing the level of efficiency in this line of work!!
Employer requests nurses be CPC due to the bills that we handle/review.
i am an HCC traveling coder
I work with Coderyte so I basically compare Coderyte's coding with our IDX-RAD
The practice paid for my schooling; that's all. They've benefited somewhat. I mostly do coding of biopsies after they come back from path. I also occasionally review remaining codes for such encounters. I have done a self-audit for the practice. I wish they would assist more in acquiring CEUs.
I work for a Family Practice Residency Program. My wish is for the interns to come with a little more coding knowledge.
I'm the only CPC in my practice and much of my time is spent returing calls after patients have received their statements, espeically from the elderly. I'm being asked to receive all of these calls and fode for four out of the nine providers; two of whom specialize in interventional radiology. I'm also being told that I must follow the A/R from 60-120 days for close to a third of the alphabet. Also, I must do all secondary submittals for the same third of the alphabet. In my opinion I should be coding more and following the A/R a bit less. until recently, I was responsibile for posting refunds for patients and insurances; which can be up to 60-70 once a month. There is more but this is basically what I am challenged with daily and I do my best t o facilitate all of this as I enjoy providing my help to our patients in an accurate fashion. Thank you.
I am not only responsible for coding/billing but all back office duties in addition.
Our physician complete their patient encounters in a coding software, so as they type the E/M note they select each components addressed in the (HPI, Exam & MDM) and when completed the software provides the level of E/M for the physician. Overnight this data will then populate the coding software and as the coder I am responsible for reading the encounter notes and confirm accuracy of codes selected and/or select CPT,ICD-9, Modifiers and HCPCS II codes for the physicians. About 70% percent of my physicians code accurately and the other 30% refuse to conform so you know all of their patient encounters have to be corrected.
As the only designated coder for a TPA I am asked to become an expert on coding from every standpoint. From validating the new code files that are used each year in our claims processing software to reviewing appeals sent in by any and all walks of medicine to participating in contract set ups as well as round table discussions with large clients.
Since I work in a billing office setting, we have multiple physician groups and specialties. We have physicians that are good teachers and great with feedback from us, but we also have some that are difficult to work with....the later is a huge drain on resources and good mental health....but I suppose it evens out, over all.
Enjoy the job as a fraud review nurse
Working at the payer I only view claims after processing and determine if they paid correctly or not. That makes it difficult when asked to code a specific seniaro. I than use all materials available to me in order determine the correct answer.
Providers only asked to select e/m if incorrect coders correct and we have a quarterly training on how to select level of services and how to reduce overuse of some ICD-9 codes.
We are a multispecialty facility. We are also on electronic office billing and soon to be on electronic billing for inpatient care. Also almost totally on electronic record keeping.
I only do the ICD-9 coding. Rarely am I asked to do the CPT codes. It goes to a billing office after I code so I have no knowledge as to the reimbursement/compliance/denials, etc.
I love my job of working with coding and billing. The two go hand-in-hand and is very important to the viability of the healthcare facilities. The knowledge gained over the years of being a coder and working with billing and A/R has afforded me the knowledge needed in order to better analyze patient reports, billing reports and to make sure that our customers/patients are given the best service when it comes to their insurance and one less worry when they come to our healthcare facility.
I work for an insurance company, so a lot of this does not apply to me. This is a new position the company has created to stay on top of all coding issues and changes.
I am an instructor that has a minimal amount of time spent with Providers. I am studying to get my CPC certification
Unfortunately, this survey is difficult to answer when there are over 700 providers. Some code, some leave to the billing staff. Some have great working relationships with their coders and billers, while others do not wish to be bothered with the administrative function. Sorry I could not answer this accurately. Nice try. Have a great day.
We have providers that specialize in the coding part. The coding is reviewed against all other aspects of coding- CMS,CCI, AMA etc...All aspects are taken into consideration before a code is used...
I enjoy my job. I have been here 19 years and been certified for 5 years.
My work environment has been very demanding and stressful. I sometimes feel like I have two full time positions wrapped into one. We do denials, checking surgeries, new providers coding and feed back, we dont chnage any codes without physician approval. We also update fee tickets yearly. Answer billers questions. Plus other tasks as required.
Mostly do the work of an A/R specialist.
I have my CPC but do only appeals, so many of the above questions did not pertain to my job duties.
I am a consultant and am currently paid per chart. I work at several hospitals in any given week, so my responses were based upon the averages I see at each of those facilities.
Coding inpatient NICU patients and inpatient Family Practice is my main job. It does include some clerical work and data entry for my own purpose to track my work. I do not do billing of any type.
I work in a large academic hospital with more than 900+ billing providers. Obtaining CEUs has never been a problem nor having the accurate tools to do my work.
Thanks a lot for the survey and please keep it up. God bless you.
I am an office coordinator for 3 different clinics. My role is more supervisory but I am the one the coders come to if they have a question. We have a certified manager that is in charge of all the clinics that provides education and direction to both providers, management, staff and employees. I believe the certified mManager is a CPC and an RHIA.
Our company codes and submits claims only after the notes or procedure reports are in the charts making it easy for me as a CPC to code correctly and accurately.
New practice open less than three mths. Things will change as practice grows. Currently I am only administrative staff w/one provider, two MAs.
I love working with all my Doctors and have just recently started training residents what an audit does to their billing. The residents have told me this is helping them understand how billing works and how their notes influence th level of service provided.
This is my first year that I have to aquire CEUs
I am the supervisor over the pathology coding department. I have 8 employees. And they are all, including myself, certified coders. Starting this year I will be teaching the class to help more employees get certified. We audit and code reports for several clients all over the United States. And am proud of my employees what we do here.
Extremely underpaid for being certified. Often get questions on "how to" code.I have found that most hospitals do not want a coder with a CPC but want the CCS certification.
Most of the survey didn't apply to me because I am a Nurse Analyst and not a coder. I became certified because i knew it would help with my job.
I code both physician hospital visits, procedures as well as office visits, procedures, labs. My main job is auditing but most of the time I am backing up the office/hospital coders. I also do CMS/Ins research for any number of topics. I also do physician education when needed, as well as staff education.
I do not work in a physician practice so don't know that my answers will assist you with this survey
Training and education for providers and their staff. We are coming up with education content to help providers and staff be more accurate in coding and be more compliant with documentation. Also doing a lot of education in regards to Risk Adjustment
I started with this practice as the biller/coder. I now have my CPC and have since taken over the responsibilities of office manager and have taken courses in that area as well. Now I am a RMM. This is a small office and it is important that I know all areas of the office so that I can fill any position if there is a need. I also oversee all the coding and bill that is now the responsibility of my biller.tq
In my job, I create edits/rules for a claims editing database that is utilized in software and other products. I also perform Operative Report Reviews. The company I work for has a coding inquiry service as well as support on coding issues for the clients that have our editing systems. My department answers those questions/queries.
I work in a small rural hospital as an outpatient coder in the Health Information Management Department. We are critical access only, so we don't have to handle DRGs or APCs. I specialize in ICD-9 coding, and I code all outpatient services offered here such as ER visits, labs, x-rays, etc. On occasion I code inpatient charts and surgery charts. There are only two coders in our hospital (both in the same department), myself and my boss who is also the department director. She is an RHIT. Until 2006 our hospital only had one coder. Our business office handles all billing, denials, claims, etc., but none of these employees have any coding certification that I am aware of.
I work at a government facility and the doctors are very good at what they do. I audit their work and I am the only coder here. They will always need a coder but they try really hard to code correctly. I appreciate them allowing me to work for them and try to present coding in a positive light.
I work for an IPA, representing over 8,000 practitioners. I am the only coder and am my own manager.
The physicians in our multi-specialty group need more training in the coding aspect to meet with compliance regulations.
I work for the military so the billing is quite different from private practice and other hospital settings. I have seen that when the provider is made to do his/her own coding they are resentful and feel we should be doing it. We audit and train the providers but it is complicated and frankly the providers do not have the time to deal with it. Thank you
Use of EHR with coding program. Providers select ICD-9 & CPT and E/M is based upon documentation. Flaws abound. Coders audit documentation and coding. Providers given feedback and education by coders. Resistance by a majority of providers since their practice or pay is not dictated by the codes or documentation (DOD,Military).
I am the coding manager for a general surgery residency; minimally invasive surgery residency; podiatry residency; family practice residency. We have an electronic medical record with an encoder. The residents and faculty chose their own dx and px codes but often select in error. Part of our job is to correct but to also educate the resident or faculty as to why we changed the code. The documentation guidelines are used in training by the faculty practice management instructor.
I am a biller first then a coder. I have the follow the rules of the insurance carrier. Some insurance carriers especially in an FQHC environment will only accept one code for the entire visit, regardless of the level of care.
I have recently been advanced into an auditor's position (4 weeks). I have not yet begun the intense work. They are developing this position. But I came from a pediatric practice and I am the only certified coder in the county.
I work for a single specialty one physician office. I basically run the office, do the coding, scheduling ect... His wife comes in about 3-4 afternoons a week and helps field calls or goes in with patients during this time. She also helps direct patients and gets information(ins cards,ect) and puts some charts together as needed. Otherwise I do all the coding, billing, insurance follow-up, and compliance which is hard with an older physician who didn't have HIPPA when he went to school but he does what I ask so that makes it easier.
Our physicians are hospitalists & intensivists who enter all of their charges into a PDA type device for downloading into our practice management software. Our billing department audits all codes for validity. Anything out of the ordinary is looked in to. ie: all high level visits, etc. All physicians are routinely audited by an RN auditor (not a certified coder) who then provides them with feedback - positive & negative. All new physicians to our group has all charges audited prior to submitting to payers & are educated regarding their documentation.
We are implementing a communinty-wide electronic medical record model. This project involves several privately owned practices, hospital-owned practices, an outpatient urgent care, and the hospital at the present time. We have family practice and specialty practices that are e-prescribing to pharmacies, doing orders and results electronically with the hospital, and sharing demographic information. We are in our second year of the project which involves building the software, training staff, and monitoring all the functions.
I am an Allied Health Instructor at a College, I teach Medical Coding and Medical Insurance
Currently, I am a claims negotiator for a large insurance company. And, I teach Medical Reimbursement, Hospital Billing and Electronic Billing in the evenings at a local College.
I have a billing company for 25 years. We bill for 150 physicians and I do office manager for a dermatology practice too. Billing, coder --they are very important people for physician practices.
In my office we do ICD-9 coding only.
Right now we have staffing issues, so I hope to get back to doing coding as more of my focus.
My position is actually AR Manager so not only am I responsible for 100% of the coding and charge entry, denial management but also Accounts receivable, quarterly reporting, financial statements to the board, registration and even facilities from time to time.
I currently work within a Business Office setting for a very large hospital based practice. I am a level III account reimbursement specialist, with my payer specialty being Medicare and the Medicare HMO and Advantage products. I also assist other members of my Appeals Team with any coding questions expecially in the area of any type of surgery.
I bill for dozens of providers. Some try to code with no coding knowledge. Some have a little coding knowlege. There are a couple that really know what they are talking about. My time is spent reading operative reports and coding according to the documentation and appealing denials.
I am also the surgery scheduling nurse for my physicians (5)practicing OB/GYN, (2)Nurse Practioner's, (1)GYN physician.
I work for an oncology hematology practice with one fulltime physician and one part time physician (1 day a week) and a parttime CRNP (3 days a week) I mainly use ICD and HCPCS and rarely use CPT.
I am a provider relations manager for a large PHO that has 1000+ members. I am asked almost on a daily basis to clarify coding scenerios. I also work with these members offices on claims issues with payors.
Please keep this confidential.
I am the only CPC in my practice.
I work for a payer and do not code claims. Most of the questions in this survey are not applicable to coders employed with payers. My job is writing business requirements. A knowledge of coding is important as it plays a crucial role to the coding/editing of the claims system. By attending meetings, I hear what bothers coders and their offices and consider these complaints when reviewing/writing business rules to see what impact these will have on members and providers.
My employer is transiting into a centralized coding department for over 200 practitioners, from primary care to surgical specialties. The specialty coders and specialty physicians are fighting the move, stating that it is essential for coder and physician to have a close working relationship. I would like to know how this works in other large out-patient hospital settings, if it’s done at all.
I am a coding consultant, mainly in large hospitals because of my 18 years experience. I can (but usually don't)perform outpatient duties. I (Not all on every assignment) code IP/OP/E&M, audit, supervise, manage, teach, most aspects of health information. Thanks
I am self-employed and code from home on a contractual basis. One of my contracts is with a company that obtains clients and disburses them among contracted coders. There are department leaders for each modality, and these leaders are to whom I'm referring as my manager in the above questions.
code for 7 specialities
Physicians seem to be at one end of the spectrum or the other as far as being open to documentation advice. Some are very willing to listen and learn and others have flat out told me that they have no interest in coding.
I manage 2 CPCs who bill surgery and do backend work for both E/M and surgeries and 2 precertification employees.
If a code is not right we talk to the provider before we would ever change the code that he picked.
I am the primary coder for a multi-doctor, multi-facility pediatric critical care and hospitalist service. This also includes some anesthesia coding for our procedural sedation services. I came into the practice with experience in multi-specialty and anesthesia coding already. I code CPTs from weekly billing sheets completed by the physician on service (not a superbill, more like fill in the blanks) and code diagnosis from the dictation done for each patient while they are in the hospital. We have no outpatient clinic, our charges are strictly for hospital services provided by physicans. The claims processing is done by an outside billing service, but they send out 1500s based on my coding. Coding is checked and edited by our finance director, so there is a check and balance system, however any compliance issues are out of my pervue. I am currently studying for the CPC examination which I hope to take in April. In this way I believe I will be able to make a more educated contribution to the coding and compliance procedures, should I be permitted to do so.
I am the coder only. I do no billing related jobs, we have billers that take care of that unless there is a rejection due to coding.
Although I am a Certified Coder, coding is not expected of my position. I work in the billing department and offer suggestions or answer questions that staff may have regarding coding issues. The coding is determined on-site by the physician and there is a seperate compliance department that does not include a coder. My duties are more in the billing department than in compliance or actual coding.
We are a outpatient facility based residency clinic. We have one coder/auditor and a biller who charge entries everything to our outside billing company. I audit 100% of our government payers for outpatient/inpatient.
Providers write there diagnosis down, coders look them up and clarify if there is some confusion as to the diagnosis. Any changes with CPT codes ALWAYS go to the provider before the change is made. They keep track of what they give us.
I am actually a practice development consultant and a billing/coding manager for a billing service. I perform baseline audits, educate office staff, redo office flow to make office more efficient as well as education to the physicians/clinical staff/management staff on efficient and accurate coding. I pick my employees from a sister company of ours where I train all my Coders and prep them for the CPC, CCS exam, etc...
I have moved from a clinical setting to a Risk Mangement setting... My coding experience is not used in my current job. However, my director/VP are encouraging me to continue maintaining my certification.
I made a move to Oregon and was hired by one manager/management team to do coding education for the providers. However, before that could come to be, the manager and management team changed and now I basically do data entry for one clinic, code by abstracting information for a 6 physician hospitalist team, and answer any questions the other billers have regarding codes, deciphering poor physician handwriting, how to code office procedures (excisions of lesions), etc. I do not feel that I am valued as a coder, like Ii was at my last job in AZ.
I am the only one that does not have the certification, all the others do. As far as the billing they do their billings, as physician doing coding we usually query their ICD-9, E&M, and they are the ones that change them for us. Iam scheduled to take the test. thank you
I do not code. I work in accounts receivable processing refunds for overpayments. This may require appeals to insurance companies due to charge corrections involving ICD-9, CPT, and/or modifiers. I have attempted the CPC test twice, however, have not been successful in completing the test in a timely manner.
For the most part, I find that the newer, more recently educated providers, do the best work with coding their own things. They have a better grasp of coding concepts, what is allowed and what is not. The older ones are a little harder to convince, but they are slowly coming around.
I am employed in a hospital setting and do all types of patient coding
I am our offices coding trainer and auditor. Very little of my time is spent actually coding.
I code all of radiology, so I am somewhat limited to answering some of these qq. reg; e/m, etc. My providers cirlce the CPT code and write the description of the dx, but all the dx are abstracted from the documentation.
I work in a teaching physician setting so documentation guidelines are a big part of my duties.
Your survey answer are too black & white, ie. agree/disagree.
I work in a university setting with many departments and a lot of physicians. There is a lot of training sessions requested and provided.
My role is that of a coding resource addressing coding questions pertaining to EOBs.
A lot of our billing is done in another city. We code here and perform data entry but the billing portion goes to the other location.
I would like to have more accessable availablity to other coders (certified)and/or resources for issues that arise that may be questionable for CPT/ICD9.
Some as these questions are difficult to answer because I manage the coding operations for over 80 providers. Some are better coders than others and some take coding more seriously than others.
I work in a small office of 6 providers, I am the front office supervisor as well as the only coder (certified or non-certified) on staff. I also work pt accts and work with our patient's help better understand their healthcare costs associated with our office.
I work for a Health Insurance company and a lot of these questions are not pertinent. You should add questions for coders in nonclinical setting.
The coding clerks are not expected to research guidelines, or communicate with the providers. We have a position that handles that for them. The providers are expected to give the coders a CPT for levels of service and an appropriate diagnosis, but it need not be in ICD-9 format. We have a separate team that handles AR clean up; the coders do not get involved in any of that. We also have a data entry team that handles any and all data entry. Work flow and responsibilities is dependent upon which team the clerk belongs to.
I do yearly audits for some of our providers, any new clients received a 10 chart audit for documentation accuracy, assist account reps with coding questions and concerns, take calls from providers regarding questions in coding, hold E/M education classes for our providers as well as outsiders.
I do not share in the typical coding job. I handle more compliance related coding issues in the structure of our EMR. I also do some consulting for our clients, but that is kept to a minimum due to time constraints with normal job related duties.
Our practice is cardio, our doctors are really easy to talk to when we have a problem with their codes, we have few denials because of the doctor, employee relationship.
In my office, coders do more than coding. We code, input, help with follow-up, all aspects of the billing process.
The items checked above as N/A should really be called "unknown"
Questions don't pertain to us at the teaching hospital.
My doctors do their own coding using a dictation system called Provation, which they can pick from lists of commom codes. I review each and every operative note, including nursing notes and pathology and makes any coding changes needed. The only time I contact physicians about coding issues is when clarification is needed or there is a documentation issue.
I do more than code for my practice. I also obtain authorizations for all hospitalizations and surgical procedures. Work enviornment is good.
I am not only the certified coder for this group, I also am responsibile for all physician credentialing.(We have 40 physicians) I feel I am an entity unto myself, I don't feel like I'm a part of the group and the only time someone looks for me is when there is trouble. I feel a lot of my coding and compliance duties have been given over to the operations manager, even though this person is not a certified coder. I want to be more involved with the coding for this group, but physicians credentialing takes precedence, which is sad, our physicians and staff coding knowledge is so poor we are not even participating in the PQRI. Right now I'm more involved in the NPI numbers and proper links than I am in the coding, which is not why I became a certified coder.
as we are all aware of the complexities of coding, the biggest hurdle that I face right now is the "timeliness" documentation is done. I have researched many insurance websites and cannot find any clear guidelines around this.
LOTS of appeals due to insurance inaccurately denying correctly coded claims.
Billing is always given the reward that coding set the ground work for. Coding is the first in my company to be looked at during downsizing.
Please keep in mind that I work in the hospital setting and my answers are based accordingly.
I code for a neurosurgery practice and just started interventional radiology. I am the only coder in the office.
Some of the questions I answered N/A were because there was not a catagory listed for my answers. Thanks
I am a very specialized coder in Anatomic Pathology
Provider fraud audits for an insurer
Since I work for a payor, my coding revolves around determining if appeal claims are payable based on the changes made by the provider, and determining if built in edits in our claims system are accurate for certain situations.
Don't really do coding as a primary. I untilize my coding in association w/my job. I work in Radiology as the IS person.
I am the only CPC over 14 practices. Their opinion is they don't need a CPC for data entry.
Inpatient facility coder
I have the knowledge and know how to code and utilize it here very rarely. If you have any knowledge of physicians who need coders, it would be helpful for you to send out that information to new coders.
My work includes much more than just coding, I have other credentials to keep up and the expense is a hardship at times. The number of CEUs expected is also a hardship... I believe keeping my knowledge current in all areas is important but sometimes getting the work done is more important than the CEUs especially these long expensive trips to conferences and conventions. More self study on line for less $$$ would be more helpful
Multi specialty coders are not my cup of tea- one should be expert in a particular field before they can multi-specialize. Even doctors has specialty. Expectation for coders in my company is extremely high.
We have over 1,000 providers & many depts/divisions/specialties, both inpt. & outpt., and they all handle things differently
We are in need of a coding and compliance manager for the organization that I work for which employs about 200 physicians.
My administrator does all the audits. I just work in the billing office and yes, I am certified. Some of these questions are hard cause we are making changes etc. I will soon be giving and inservice for all of our staff and doctors on some of their coding issues.
Remote...clients are in California and in New York
I would like the Coders to have a better understanding of the guidelines of ICD coding and be more assertive and communicative with the providers.
I work for an HMO, performing audits of claims when coding issues are identified.
I work on the payer side and not many of the question's had anything to do with that.
I am a coder for an intraoperative neurophysiological monitoring company. I wish there were classes/seminars, ect related to this subject. I will be attending a coding course for this in March by the American Society of Neurophysiological Monitoring . This is the billing that I do for my company and would love to learn more. My company is sending me to her class on this...but this will not go toward any of my CEUs although this is my specialty.
I am the only coder in this office, and pursued my credentials after I had been here, in my present job, for several years. So, although my employer takes advantage of my coding knowledge and experience in handling appeals and so forth, they do not require a coder on staff. I work for a Managed Heathcare company (PPO) that contracts with both payors and providers, so I interact with both. We are also a MCO for workers comp and I price those bills to the state fee schedule for our comp customers.
I audit the physicians level of service; making sure they are in compliance with 1995 E/M guidelines. I also educate physicians on E/M coding.
I work for a IPA medical group we are delegated to pay claims by the health plans. And we are also on the other side of the coin submitting claims in behalf of our doctors. Therefore, I update our system quarterly as new/deleted codes are received. And I also process claims appeal, answer questions for claims examiner regarding proper billing etc.
I am and have been the only coder in my practice since the separation of duties in 1998.
This could all change when electronic medical records are finally implemented in our clinic. The doctors are going to have to do more coding and make sure their dictation is correct.
I am in charge of coding and billing of the hospital charges for my physicians. I work with our billing service when it comes to denials. They request a review of the charges and I give them advice to rebill.
As a payor office, it's not about fewer or more denials, it's about appropriate denials that can be backed in the industry. Same with faster or slower reimbursement. Maybe the percentage of certified professionals aren't from payor offices. This would be a good statistic to know. Conferences should also hit the payor side of the topics as well as surveys. Thank you.
I code for the DoD, so we do not have reimbursement issues. The DoD coding software needs improvement, and documentation is not ideal or easy.
Our practice has branches throughout the United States. Coding is a mixture of manual and electronic CAC coding through CodeRyte. While I am the only coder at my location, I have backup and resources available from all our other subsidiaries. While my physicians may use charge sheets for some procedures they do expect 100% review and do not do ICD coding.
I work on the payer end of claims, but I am able to appreciate the complexity of coding and at times am called upon to code for third party bills from demand packets. I hope to eventually get into auditing and or billing at home.
I am a surgery coordinator, and I use coding primarily for Prior Authorization purposes. I work for a 23-year-old practice, and I am the first certified coding staff member. My employer's long-term plan is for me to eventually move into billing/claims management.
Some of these questions were difficult to answer accurately, and do not reflect the wide range of responses which would truly represent the practice. I work with multiple providers. Many are good at documenting and coding appropriately and welcome any suggestions or new information. Others do not.
We are hospital based physican group. I am also finance director and coder
I review and place all of the new, revised and deleted codes (CPT, ICD-9, HCPCS and revenue codes) in a payors computer system so claims may process.
I have asked for additional education. waiting for reply. I NEED ADDITIONAL ADVANCED TRAINING
Table didn't show up on my questionnaire only drop down boxes.
In my office professional coders may not review the EOBs, but I do help with the appeal letters.
I am the only coder for our group. In addition to my Coding Specialist position I am also the front-desk Supervisor. I am responsible for all CPT coding with the exception of one doctor in the group who does his own coding. The physicians in the group do the ICD-9m coding on E&M services. They also are responsible for completing the encounter form for office visits which is scanned and then edited for accuracy by myself. The practice relies on an outside reimbursement Specialist to perform chart and coding audits.
I do the coding for 4 Trauma surgeons, and one general surgeon. I do all the denials, correspondence, and edits. I have to make sure that all the billing sheets are up to date. My trauma surgeons have hospital rounds that they do also. (Which is very time consuming)
Most of the education forums (like the Cutting Edge magazine or even this survey) seem to be directed mainly at physician practices. Please bear in mind that certified coders also work for many of the payors in the field.
I am a consultant and the majority of my work is done performing baseline audits for practices as part of a compliance plan and performing expert rebuttal reports for practices defending themselves against post payment reviews and audits. Typically I am retained by an attorney to perform these services.
I work for 13 orthepedic surgeons that take call in the ED at the local hospital next door, they are all very good coders and we educate them every six months on areas to improve. We have two certified coders, myself and my boss.
Currently there are 3 CPCs in this particular office. 2 batch/code M.D. invoices & perform data entry of these invoices. One CPC researches/resolves coding edits & coding/documentation denials. This is a multi-speciality practice & entails a broad scope of coding expertise & constant learning. We handle a high volume of work for the # of FTEs. It would help if the AAPC offered more area seminars during the calendar year at a more reasonable fee....the fees have gone up over the last year but the majority of us are still trying to manage on the same wages while everything around us goes up. - The "Test Yourself" exam is of help but the synopsis of articles has been reduced & that's another hard-ship for some of us. I think there needs to be a more "creative" approach for the CEU situation.
Since I am not coding, but rather auditing coders, many of these questions do not apply. I tried to answer some of them that I felt could be applied in my situation.
I would like to see more free coding CEUs through businesses like the pharmacy technicians get free through drug companies.
My work is specialized in pathology. The pathologists provide us with CPT codes and our staff handles the ICD-9 coding based on the pathologists findings.
1. I wish to see more claims from start to finish, from encounter documentation to coding to billing to reimbursement. 2. I wish to see dx & cpt & modifier codes truly describing the encounter get paid instead of using codes simply to encourage payment. 3. When a claim gets denied, it should return to the coder to see why it was denied. 4. I wish to see more emphasis on consistent e&m coding from all entities, ie more Marshfield clinic-type tools. 5. I wish more training on the risk of complications and/or morbidity and mortality.
The answers depend on which dept, which physician, whether there is an assigned coder. All depts are different as far as coding. We are audited frequently and share the results with the auditor, coder, physician.
As a coder, my job is easier than a coder from a provider office. It is not my responsibility to necessarily determine the correct code, however, it is my responsibility to determine that the appropriate documentation supports the code billed.
I code for a 3 physican office, with a large off site billing department.
I strictly do post-payment audits and coach doctors on documentation compliance. The newer (recently graduated) doctors are quick to accept any change, but the more established doctors fight the change. It is a work in progress. We have 67 doctors in our specialty practice.
Because this is a multiple physician office, your questions were difficult to answer because some of the docs are good coders and some are terrible. They all are willing to get better, though, so that is a good thing.
I cannot answer all questions as I am a coding review nurse for a large payor. Questions starting with "Physicians in my practice...." do not apply to me.
Our clinical coders are NOT credentialed. And that makes my job all the more important, I am a coding coordinator and edit all of the claims that hit an edit in our system. I help all of the 500+ physician's staff code anything they are unable to and help them correct what ever is necessary. Most "new hires" for coding have no experience at all.
I am not given the opportunity to do as many internal audits as necessary. Non-Compliance is a major concern for me. We are working towards it though. Freeing up more of my time to do more audits.
I am an RN so I have patient care responsibilities. My primary reason for being a CPC is to coordinate the compliance program. I do not get involved with billing issues.
Training Specialist @ a medical insurance office.
We are on an EMR system and the coding choices picked by our drs have gone down in accuracy since we went live on EMR
Working on the payer side, my main duty is to review coding related appeals. I also do testing with upgrades, upgrading our coding software yearly and am currenlty working with our providers on ways they can improve their coding to get their claims paid appropriately the first time.
We do not change our providers coding until we have spoke with them and they have reviewed to make sure that it is correct and follows what their documentation was in the patient record. My employer reimburses for most of my CEUs, I have purchased coding resources, and training manuals in the past.
My company has an allotment for continuing education. We review a precentage of billing before it goes out to the payer.
The doctors are well knowledgeable and are great to work for.
I work for a primary care physician group consisting of 50 physicians at the moment. This position I am in was only created in May of 2007 and so our physician education really only began in June of 2007. We have a long way to go as many of the physician were in private practice and did not have to comply with a formal corporate compliance program as we now have. It has been very challenging and I am the only coder at the moment. Our billing manager is the only other certified coder. We hope to expand in the next few months and hire at least one more coder to help with the education and auditing of the physicians.
I get all of the coding resources that are essential, ICD-9, CPT, HCPCS and a couple of reference books but we could use a few more that I thing are essential such as the CPT Assistant.
I am a nurse-auditor...an RN/CPC who works for a payer and audits questionable billing patterns of professional providers.
I have the unique pleasure working for an IPA as the manager of coding and compliance. Emphasis is put on trying to get it right from the moment the appointment is made. The management is very in tune with how coding affects the entire process.
I work in a multi-specialty teaching physician environment and it is very complex. Most physicians do code their own E&Ms and other clinic procedures. Inpatient visits and surgical services are abstracted from the medical record or other documentation. Some MDs value the coders and others do not.
I am the clinical editor and set up the system in regards to claim processing with correct coding. I review all questions regarding coding. We have 11 CPC in our office and I work for a payer. thanks
I am the only coder for our practice of one vascular and five cardiovascular surgeons. I have an excellent knowledge of transcription having done that for 15+ years. I have done coding for five years having learned the basics from a previous office manager and then adding to my knowledge from various classes, books, etc. I am thinking of studying for my coding certification although I have found that CPCs in our corporate and compliance department often cannot help with speciality coding. They have a very good overall knowledge but I wonder how this would help me in a speciality office.
I coded only E/M
The medical is unique, in that we have a good compliance department that helps with everything. We have a university wide audit and an internal audit annually for each physician.
i work in a rehab agency for physical, occupational and speech therapists. We have several locations that I do all the posting of charges and follow up on the claims with the payors. the coporate office post the checks in the system but i work the denials and appeals. I am the only certified coder and have been working in office settings for over 20 years. It is hard to get them to understand outpatient billing and all the demands by the insurance carriers and fee schedules. They are used to working in SNF which are consolidated billing. they expect me to do a projected revenue each month and I am expected collect that projected revenue each month. They do not understand that everything is based on eligiblity and benefits at the time services are rendered by the patients and patient and insurance companies never pay the amount you project. There are many factors involved (deductibles, co-pays, co-insurance, max benefits, medical necessity. I told them in a perfect world we would collect 100% but in the insurance world.
I work the CCI edits, appealing the denials, and working on better ways to educate the physicians in the specialty areas on the do's and don'ts of the pathology/laboratory guide lines. We are a huge organization, and there are numerous test done at our facility daily. We even receive outside lab to be diagnosed. This is why more information and education on the pathology/lab end is so important. Also with related workshops available, this will justify to upper management the importance of having credentialed employees, and pay to keep their credentials current.
I do the billing for 2 doctors, 2 ambulance services and do coding for an ASC all from home then I work at the ASC 2 days a week. None of the doctors do any ICD-9 coding they just write the diag and I do the coding. As far as the OV charges they go off the charge sheet that has been given to them.
My practice involves ICD-9 coding and selecting the appropriate code based on the assessment of the patient and the physician treatment plan. It requires the skills of a nurse along with the CPC certification to do it correctly. The reimbursement is tied to the diagnosis code so it is imperative that agencies use certified coders to obtain appropriate Medicare reimbursement.
At the billing company I work for, I am not allowed to code any longer. We use an outside coding company. It is my understanding that a coder who works for a billing company is in a position of "conflict of interest." Meaning that, as a coder, I could be accused of upcoding in order to increase reimbursement for the physician so that it would ultimately also increse the amount of reimbursement my billing company makes off those claims. I am not sure I completely understand that position/perspective. I really miss coding and I am currently looking for a position in a physician's office. I would like to once again have the experience of working closely with a physician on compliance and coding issues.
My hospital is all for education and encourage us to attend sessions and listen to audioconferences.
Meed more available classes for providers to attend to get them more familiar with coding/compliance/documentation rules.
Working with the military, the outside reimbursement isn't as important as capturing correct "manhours" from correct coding. Instead of "money", they get "manhours". I strictly audit three very large clinics for over 40 providers and many corpsman.
I do the coding and billing for the hospitalists. There are 11 of them at 3 different hospitals. I code the ICD-9 DX and the CPT code they pick for visit. I have to research the CPT code, often changing it from an OBS to In-PT. The DX codes are billed as written on the rounding sheet, only 4 DX per bill. I am learning a lot about the insurance side and if the codes are wrong, I find out when the claims have been denied. It's been interesting and frustrating at the same time, as am not sure what role I'm really taking.
We do not have a coder in this office. The providers do all their own coding. I act as a coding resource and my main function is compliance auditing.
I work (QCing)encounters for a couple of large practices and a couple of smaller ones. We do not have enough coding analysts to do all what is expected by our employers. From QCing the coding of encounters, to working the edits, to working with dept. liaisons, and to writing appeal letters for several physician groups is a lot to ask for one person.
I think with the large number of physicians and services performed in our practice, that we have a great working relationship between physician, coders and billers. Our office employers 2 certified coders and serveral billers which all work together to bill and code accurately and efficiently. Each person performing the tasks they are best trained and suited to do to complement the workings of our practice.
The flexibility I am given in work hours is very important to me.
I would like to see CEUs available for Hospice coding.
I'm the only coder, certified or non-certified!
As a consultant for a CPA firm whose medical practice clients began asking for help with compliance about 7 yrs ago, I am in the somewhat unique position to have physicians ask me what I think about their documentation practices from a compliance perspective - which many in-office coders do not enjoy. Evenwhen they ask, physicians don't always want to hear that they need to change - they want to hear that what they are doing is fine and dandy. I think it's important that coders try to keep in mind the changes the medical profession has faced due to various legislations in the the last 10 years or so, and not take resistance or even some resentment too personally. Our MDs need us and we should try to not get frustrated when their MDs balk at making more changes, and try to make transitions as easy as possible for them. The most important thing is making sure they know they need us so they will provide the resources and continuing ed. we need to do a good job for them. Make sure they get good value for their money.
Coding audits are a small percentage of our consulting services, therefore many of the details you are seeking I am not able to give feedback.
I also participate in payer contract negotiations. Physicians code E&M only, and coders code surgeries and quiery physicians when there is an issue or question.
I just started with my present company but would like to see more flex time and work from home. I'd like to see my supervisor become more knowledgable about coding. She pushs for things to get done but she doesn't realize the time it takes to lookup iICD-9 codes to make sure that claim is coded correctly. I think if she understood coding she would be less likely to hound the coders. And I'd like to see us less pressured about break times. If 2 minutes late from break, she is on your back. I think we should get 15 minute breaks instead of 10. Once again a manager of coders should have knowledge of our background. It would be nice if she took a coding class or two.
I am a senior medical coder at a general acute care hospital. I code inpatient charts, day surgery charts, Inpt Rehab charts,referred outpatient coding list, hospital physician office coding list, recurring outpt coding list, and occasionally SNF charts, BSU, detox, and alcohol/drug rehab charts. We also sign out and file our own charts to the incomplete room, search for unbilled charts that have slipped through, do physician reviews monthly, and quarterly coding reviews. I also take care of the trauma registry and congenital malformations registry. There is a lot of work for not nearly enough pay, but I love my job. We have a very understanding boss who lets us play the radio and talk among ourselves as long as the work gets done. She is also lenient about changing our work schedule as needed.
I am an auditor and educator with over 14 practices and I am the only certified coder. The president and practice manager feels anyone can enter charges and that no revenue is being lost. The doctors are filling out encounter sheets.
Coding is a very nice field. I like it very much.
Unfortunately my employer does not realize or understand the importance of correct coding in relation to compliance. They do not wish to venture or offer any more than neccessary for continuing education nor is it understood by my employer the constant changes and updates that are beneficial and required for any practice. It would be wonderful if my employer would listen more carefully to what is being said and the importance in regards to coding.
I code for numerous Emmergency Rooms across the country. As I do not work for a practice/Physician it was difficult to answer this survey.
I would like to spend more to be able to attend at least one conference per year. I miss the discussions from all coding backgrounds at the national meetings. I have only been able to attend one local workshop over the last 4 years do to cost and my lack of extra funds. I am really glad to see the reduced cost and more local workshops that mean less travel expenses which will give me and I know more members a changes to network.
2 dr / 1 LPN / 1 PA / 3 staff / 1 Mgr Urology Mrg is the only coder, uncertified, i think I'm one of the 3 staff, not really coding yet, but anticipating full-time coding by August 2008 I am a BS, BA, CPC-A
inpt day surg, outpt and ER hospital coding so the majority of this survey did not apply to my work situation
I work in an environment where I am the only certified coder. I am the Asst Practice Administrator by title. My day consists of various duties that require the knowledge and ethics of a certified coder.
I don't feel that anyone really cares if I am certified or not.
I would like to see more Orthopaedic topics in continuing education seminars, locally.
I also work as an independent consultant. My payer employer is responsible for all education related to the payer business. I am responsible for all additional education that would not benefit my payer employer. This works well and I am able to obtain a wide array of education in various topics.
I love coding and the challenges it continually brings. I worked/work very hard for my certification. On a different note, I have recently discovered that there are companies that are outsourcing coding to other countries, in turn taking away American jobs. Even more disappointing is that the AAPC is supporting this. VERY DISSAPOINTING!!!! This is something I think future coders here in this country should be aware of.
This survey is specific to physician office practice, not for coders employed by a payer.
There is only one coder in the practice for 2 physicians. They are vascular/thoracic surgeons. They use an encounter form to circle the type of office visit which is confirmed with the dictation. Coding is not performed until the dictation returns to the office from the transcriptionist. The coder also handles accounts receivables.
Although you indicated Payer as an option at the beginning of the form - none of the questions were payer oriented - so I ended up clicking NA on most or skipping the question altogether. Maybe you need a separate form for payers.
I am a manager of 26 Certified coders who bill for 25 fee-for-service groups in the ER.
Work environment is located in the Medical Records Dept within close proximity of patient registration and front lobby, very noisy and distracting. All coding, data entry and auditing is done by coders and all billing is done by Business office.
I work for a home care agency and we use the PPS. We only work with ICD-9 codes. Their are no doctors working for us. We go to people home and the nurses will code with the help of myself. I'm the only coder here due to were a small agency.
I am a billing manager for an internal medicine practice with 2 physicians and 3 nurse practitioners. I am the only certified coder and biller in the office and that is only because I asked to become certified and he was willing. Certification was not a preferrance but it has increased reimbursement. If I ever left this position, I am not positive he would look for certification to be a prerequisite.
I've worked here going on 4 years and I have gained an enormous amount of knowledge about coding in all areas which has allowed me to advance from being non-certified to being certified. Moving onto being a Senior Coder and now I am a Supervisor of Coding. The possibilities are here if your willing to work and achieve, I am always learning on a daily basis.
I am the office manager and oversee the coding and billing staff
It would have reflected better for me to have answered with sometimes as an option to select for your colums.
I do hospital based physician fee coding- surgeries,b deliveries, consults admits, er visits, f/u hospital visits, discharges, newborn admits, f/u visits and d/c's. etc. I do this for a variety of specialties including: ob/gyn general surgery, urology,ent,pediatrics. Some otpt surgeries including the above and ortho and pain management and dental for the physician side
I audit and review pre and post charges for correct coding and documentation. Answer coding questions and review some denials.
I provide contract work and get reimbursed by op-note monthly.
AS a coding Manager, I supervisor 10 coders as well as educating Providers and Residents. I also do some of the coding for several of our multi specialities. I meet with new Providers to asses their level of coding knowledge and educate them on the requirements of our practice. I also audit the coders and provide onsite education to help them improve their skills. I attend Provider staff meetings to educate them on changes as well as issues that the coders find when coding the encounters.
I am a working Business Office Manager who has been in the coding field since 1981. I had great mMentors and I train my non-certified staff office to be very detailed oriented individuals. We work our EOB denials upon entry of payments that way nothing gets layed aside to hopefully do later. We review all charges and diagnosis on a report prior to electronic billing. We are also an electronic record practice and that has been the greatest improvement productivity wise to allow more time to do coding reviews. Every physicians office should certify at least one coder. Without a coding expert- who does not know it all but has the mind-set to know where to go-is vitally important to the practice.
The work I do allows me to do coding, however I would like to focus more on specialty coding for specific practices.
We have one Physician & one PA. We use a superbill, but I sometimes have to pull the chart to get a dx that would classify the CPT per CCI edit. I also on occasion audit the E/M coded by both.
Our physicians code, but the certified coder make sure no bundling and if they have this is reported to them. Also all information on changes with the CCI are brought to their attention
I am the only certified coder (billing staff of three) for two clinics. 1 physician (medical director), 2 physician assistants. Soon to add another physician and nurse practitioner. I work four days a week, 10-11 hours each day.
there are 3 CPCs in my office that handle verifying insurance & contacting pts prior to their surgery, coding and billing insurances and posting insurance and pt pmts. plus any followup or appeals. With so much information changing daily in the coding/insurance world we are overwhelmed trying to keep a hold on it.
I am required to keep an account and record the number of the patients admitted on a daily basis to the department and also if the patients were referred to the department or transferred from a speciality service. At the end of the month I must report how many deliveries were performed for each provider to the department administrator so the providers can receive a $100 bonus for their deliveries. I must also send the department chair a copy of the census for the month with the total amount of patients admitted and also assigned to what team, ie. 10 patients admitted to yellow team for the day. On occasions have had to verify a physicians cridentials.
I am a Physician Liaison/Coder, part of a outpatient coding department of 20 certified coders in a Clinic & Hospital setting.
I am currently working for a non-profit clinic. I work with encounter forms which the most used codes printed on the form. So, my coding it's very limited. So, most of my work it's reviewing and data entry.
I am the only certified coder in our practice. There are 2 physicians who mark their own codes however, it is my duty to check them for accuracy.
I have only been with my current employer for 1 1/2 years. I am still trying to implement changes from knowledge and policies that I brought with me from my previous employer of 23 years. I have found that just because someone is a CPC does not mean they have a understanding of coding and definately not how it translates into optimal and timely reimbursement. The department is divided up into three teams - coding and charge posting, payment posting, and insurance follow-up and collections. Unfortunately, neither team willing shares issues and/or information with the other teams making it difficult to for everyone to see the circle come to full closure.
I am employed by a multi specialty practice with over 20 physicians. Most do not code their own work.
Outside resources are very important. Meetings with other LTC facilities and RRHIMA members help with support questions.
I do radiology coding for a multi-provider office.I also do Workers Compensation coding + billing for E/M inital visits and follow ups as well as Physical Therapy at our occupational health clinic
My profession right now is practice management. I help physician with start up practices.
I work at a durable medical equipment company as the medicare billing coordinator. Most of my time I am working on billing issues. Often there are coding errors from the information we get from the doctor's offices. I am the only CPC in the office. I correct these issues and code when the orders come without the dx codes written on them.
Many coders do not work in clinical practice settings. It may have helped the survey if this instrument were designed either for all settings or asked if the person works in a clinical setting and if not, were told to skip to #8.
Strictly coding all day. Work for government so we have additional VA directives for coding some of our cases in addition to all other guidelines. We have no charge master so we code everything (labs, radiology, drugs, PTSD clinics, etc)
The doctors do pick their codes but they are reviewed by the coders. The codes are picked so surgery authorization can be done prior to surgery. Codes are accurate about 85% of the time.
While some of our providers are very good coders, others are not. We audit all consultations and level 4 & 5 visits and do the majority of the surgical coding according to the documentation provided in the OP note. The majority of our providers are receptive to our comments and suggestions and do their best to adhere to coding guidance.
100% audit with start of EMR. RN office manager more concerned with clinical staff then coding/billing.
Our office has only one coder, which is me I always review the physician's coding for accuracy and should I feel a code is inaccurate, I go to the physician for his review and he is the one to make changes.
I work in an environment that is departmentalized. I only diagnosis code. We have surgical coders, surgical pricers and a Data entry dept. And as a coder we do none of the patient/billing. That is also a seperate dept. I telecommute and enjoy every minute of it. I get a lot more done and my hours our from 6:00 am to 2:30 pm. We have monthly meetings and the team work is excellent. All of our work is electronic and efficient and up to date with any current changes in ICD-9, CPT, HCPCS, DRG etc.. We have a team called enterprise coders, if we have questions about what we are coding, that they can assist us.I am very pleased with my job and we are always educated and trained on new information in the medical coding field.
Do you have an position open for hire?
I really wish the providers had more knowledge of the ICD-9 and CPT codes. I think it would help them dictate more accurately in terms of what choices are available to us when we are coding.
Tiis survey was somewhat difficult. I use my coding when I program benefits.
I work as the office manager for a clinic of one two providers, one physician and one NP. We recently were purchased by a local hospital, so we are a provider based RHC. I also am a CPC so my work functions also include coding, billing, collections, ect. I also input data into the health dept system for the tracking of immunizations.
I have a great work environment-of course there are ways we could improve, but overall I think we do a great job. Our doctors and very concerned that we report what we do and report it correctly. This is taken seriously.
I am credentialed but coding is not my primary duty; I am a patient accounting manager and have been for 25 years. I happen to prefer the medical records side of things and pursued coding on my own.
I review the daily claims and clean them up and submit them to the clearing house. I check all the reports from the clearing house. When the checkout staff has problems with ICD-9 codes they come to me and I use my current books to give them the code to the highest degree of specificity. The doctors (2 internists and 1 cardiologist) use non-specific codes most the time. I also post the lab, CT/CTA, pacer checks and hospital charges. My daily duties are also doing the daily close-out and getting the daily deposits ready, as well as addressing patients' billing questions, insurance questions, making appointments, getting authorizations, posting ins and patient payments. I also answer the phone when the calls are not picked up by the appropriate department and send messages or help the patient directly. My work environment is high stress.
I do all coding of claims, data entry, appeals, and education to physicians and staff. Post all payments from eob's. Review contracts, ins newsletters and manuals and update staff and physician's re: changes etc. Send statements, collections, and phone calls re accounts.
Rate of pay: $13.75 per hour
Work w/ payor, so many questions not applicable to my situation. I review documentation of medical records in providers' offices. Sometimes documentation is very good and coded (correctly) sometimes hand-writing is terrible, documentation brief w/ no conclusions. By-in-large, documentation is good.
I would like to see more Home Health Care Resources available through the AAPC. Often times in HHA Coding there are scarce resources.
The providers I work for use a fee ticket which does have CPT/ICD codes available to them but they do expect us to evaluate them for accuracy based on their dictation that is why my answers are such for the provider section. I do believe it does help me because it can at least tell me what he think he did so I don't miss anything.
When others do the coding and create claims and when claims get rejected I'm the one responsible to follow up, and is frustrating because they don't pay attention on what they do since they don't have to worry about correcting or geting rejections.
Academic practice with 200+ providers in a multi-specialty environment.
I am a team leader in our billing department and we also have another CPC who does auditing. We have electronic medical records and our system codes the providers' visits. Our biggest problem is the provider's documentation and the fact that the provider can overide the systems' coding of procedures.
I am the only coder/biller in an oral surgery practice consisting of 6 oral surgeons. Prior to me, the position has never been held by a certified coder. Our doctors are resistant to change and are only now beginning to be more open to changing the way they document, etc. (I have been working on this for 5 years.)
I have been coding and I need to get certified. Any study guides out there?
Because I am self-employed most of the questions did not apply.
I work for an insurance company as a Health Care Fraud investigator.
Full time Healthcare Auditor
It was hard to answer some of the questions because I am the only coder in the office. I work for a Hospice and HomeCare agency and I do basically only ICD-9 coding. I have found that there aren't that many coders in home health care. Most the coding is done by RNs that dn't have coding experience. I have been able to help educate them on proper coding.
We are a multi speciality group. Some providers can pick the E/M correctly while other are not accurate. They write down the diagnosis but do not pick any codes. Hospitalist and specialist can pick the correct level of services for their inpt but do not pick the ICD-9
I believe coders should stand alone in a practice and have direct contact and rapport with the physicians. Administrators do not need to cushion or try to be the middle person between the coders and the physicians. It can only cause communication misunderstandings. Administrators who think they are coders just because they have been in the business of managing a practice need to step aside and let coders do their job. It all falls back to the coders in the end if the revenue falls. But let the revenue increase and it seems the administrator wants to be "coder".
There are two of us that manage the 24 providers in 12 different offices and it is a huge task as we are off site, across the street. We work for a corporation and it is extremely difficult to make sure everyone is doing what they are supposed to be doing with regards to coding. We do have a billing company but the charge input is left to the front office personnel which are not trained with CPT and ICD-9 coding. There are a few employees who are trained and these few people are available to help. The billing company does monitor the charge entry every day with closing reports. The structure of the corporation does not include a coder in each office. This is very frustrating to those of us who are managing and trying to keep up with all the errors that are made. Any suggestions would be greatly appreciated.
I would like to have more classes on billing for commercial payers.
My experience, working in rural Pennsylvania, is that there is both a shortage of qualified, experienced coders and that providers and facilities do not wish to adequately staff the coding departments due to budget constraints. As we are not viewed as generating revenue (I disagree with that view), our coding department is extremely short-staffed. We have 2 certified coders for approximately 60 physicians, approximately half of them being surgical practices. I and the one other certified coder do all of the surgical coding, including an ortho practice with 5 surgeeons and a cardiovascular surgical practice (CABGs, AAA repairs, etc) with 2 surgeons. She and I are also responsible for educating physicians and compliance issues. Our coding duties are in addition to our supervising individual practices, which includes personnel issues, patient and clinical issues and JCAHO/Dept of Health compliance.
I am an instructor and it is very difficult to attend the audio conferences as the classrooms do not have a phone capabilities. I am off on Fridays and the conferences are never offered during that day of the week. I would love to attend more CEU conferences and/or audio. It would be great if there were computer type seminars to earn CEU. In my position it is very difficult to take time off to attend anything out of town. My students look to me for answers and knowledge and there are times that I do not have the answers and my resources are limited during class time. I do have internet access and phones which are located outside the class room and therefore any questions asked may take a few days to get proper answers to. I have over 10 years experience and much to share but each year that I am out of touch with medical offices I miss some of the changes that they experience. Any materials that would help me in my field of work would be greatly appriciated.
There needs to be a specialty certification for Ophthalmology. At one time one existed and I achieved that goal and would like to have another. PLEASE try to make the achievable. Thank you
My only comment as being a coder in the state of Maine I find that there is a lack of specialized coding lectures or workshops. In order to go to a workshop that applied to sugical coding I had to drive 7 hours away.
I also copy all outgoing medical records/audit lab and path monthly bills and am in charge of our off-site strorage of charts.
I am a billing manager with an old medical software program so knowledge is key!
I'm in Provider Outreach and Education for a Part A Medicare Intermediary.
I have worked in Orthopeadics for over 8 years. I was a nurse for 3 years and then moved over to the business side to learn billing. I moved to Columbus about 2 years and was hired by my current practice. I have been given great opportunities that included obtaining my CPC, a year later my CPC-ORTHO and my resources are unlimited. I think that the advantage I have is that I work for a smaller 4 physician practice and am the only coder/billing specialist in the practice.
Our small family practice (4 providers) is extremely supportive of the work I do. My knowledge base comes from years of correcting denied claims and dealing with insurance companies. I finally convinced our practice manager that coding clean claims "up front" made much more sense than correcting denied claims "back end." For the past six years I have been the only coder but I have recently begun training an apprentice so I can take a guilt-free vacation! I love my job and actually read coding books for fun!
We are a large orthopedic group. All front-end coding and charge entry is performed by the certified coders on site at each location. Denials and EOB work is handled at our Central Billing Office where there are 2 certified coders on staff.
Even though I have my CPC I actually work more with appeals and reviews. My background was claim processing for 20 years.
I am employed in a teaching facility for medical students. Therefore, I am engaged in coding for SEVERAL different specialties.
I work for a large coding/billing dept which is responsible for overseeing the coding of over 200 providers. We see all levels of accuracy from our providers. Also, some use cheat sheets, others don't; some had formal education, others didn't; etc, etc. Their accurracy, expectations, etc are all over the map.
Sometimes, the hat I wear is that of a date entry person....I post clinic fee ticket charges and payments made by patients. I complete the bank deposit ticket for the weekly deposit. One of the surgeons here and one of the pain management physicians here are 95% acurate on their procedure coding, and I fine tune as needed with more specific diagnosis codes, modifiers, adding or dropping CPT codes, etc. The other surgeon is 65% accurate with coding procedures, but the fine tuning includes finding the date the procedure was done, the diagnosis code, and verifying the CPT codes turned in, or actually coding from scratch. I keep up with the scheduled ov appointments and procedures; if I do not receive fee tickets or codes, it reconcilliation time.
Were I live the doctor's offices are only interested in billers and not in coders, if you don't have any billing experience you have a very hard time finding a job. I was lucky in the since that my doctor was willing to work with me on the billing experience since he know that having a certified coder is a added bonus and that he will get paid faster and correctly since his claims will go out correct to begin with.
I must convert a .pdf op report to a Word file and also must do data entry of demographics (10 fields) for each patient's record in our in-house software application, before I ever get to code an op report. Coders are expected to code at least 40 op reports per day. If we average 50 op reports or more per day with a 95% accuracy rate, we qualify for "incentive" pay. It's not uncommon to put in a 12-14 hour workday to achieve "incentive" pay.
I feel that the management does not value the credentialed coder they don't place ads in that manner and don't try to push employees to obtain CPC after hiring. (Some places require after two years of employment) They due purchase current coding books, but not willing to send to specialty seminars. They do not understand that each specialty is unique, each ins carrier has different manner of coding for the same thing. Manner just wants claims moved out the door.
We have many clinics in our system some are speciality clinics. Some providers do well in coding with surgery others do not bother. Educating providers is hard because there is never enough time when seeing patients. Our company is aware of the benefits of having certified coders. There never seems to be enough time to catch but but we hang in there.
University Teaching Physician - Surgery Specialty Coder
We dont have a lot of support in our clinics for coders. We are given numerous responsibilities above and beyond coding and our pay does not support our duties. It is always a struggle to keep up with coding, and do it accurately and have enough time to research a problem.
clinics are great, system is bulky
Some specialties have designated coders who code prospectively with no physician involvement in code selection. The physicians paid up front to have these coders in place. For some other specialties the physicians code but the coder reviews retrospectively due to identified compliance issues with certain physicians. Unfortunately, the billing company has had to take on this additional expense. I think some of our physicians have an expectation that every service they code will be reviewed by a coder before being billed, yet the physicians do not want to pay for this additional expense.
There are 11 physicians in my office and i am the only coder, there is little time to do any audits, there needs to be at least two so that an audit can be done to insure the accuracy of coding. The pay is not what a certified coder should make but what someone with no experience makes. I can't make them understand that and this is why coders look for different jobs in hospitals rather than offices because of the pay.
I do strictly entering charges for all physicians and pa's--I do some pre-certification.
I am the office manager and the certified coder for the office. I code all of the operative reports for the physicians. I also perform monthly random audits of the physicians office charges. I enjoy what I do!
This job is coding for E&M and Surgery. Audit all charges, code surgeries and data entry.Pre-cert all surgery and answer billing questions for pt and financial counsel. Review email from our Business service center on denials. Review reports for payments and to check that all charges are in the billing system.
In a small office all personel assist with compliance & coding documentation. The more information shared with the doctor on documentation & ICD-9 coding ehlps assure we are able to support the services charged. The information I receive at seminars is shared with the doctor.
I wish I did more coding, but unfortuately at this time I don't. I have applied for different positions in the organization.
The company I work for has multiple hospitals and physician practices. I work in the Coding and Compliance department in two of the out lying practices. I am the person the Physicians come to with questions about insurance and Medicare. I code the encounter forms and link the dx codes with the correct procedure codes for charge entry. I work the denials for both practices and education the physicians on any changes in Medicare guidelines as will as researching any issues or questions about individual insurance policies. Training on correct documentation and what needs to be improved is given to each physician.
I work with 6 surgeons and part of them do their own coding and part depend on me to assist them with the coding (CPT and ICD-9-CM). I check all coding with the documentation to see if they agree. I key all the charges for their inpatient and outpatient surgeries as well as E/M hospital charges.
The VA is an educational facility. I work with Quality Management regarding Resident Supervision and compliance via chart auditing and daily interactions with all medical disciplines within our hospitals and clinics here in my healthcare system.
Front to back end medical billing for an ASC, including charge entry, electronic and hardcopy billing to insurance companies, follow-up on unpaid claims, patient statements, customer service calls, setting up payment plans, collections, refunds. Also review coding and billing error for primary care physicians.
I manage eight billers, one clerk and two coders. Only one coder is CPC certified. I taught the other one to code and she is currently working on becoming certified. I spend a fair amount of time on a regular basis teaching the basics of coding to the billing personnel.
I have worked as a coder for 12 years in a variety of physician offices. I have had my CPC for about 4 years now. Recently, I have met two people with AHIMA coding certifications. One of them is currently studying for her exam through AHIMA. Their study and knowledge of the human body and it's processes is much more rigorous than what I learned through AAPC PMCC instructor led training. I think that the AAPC should create a program or even another certification, that is related just to anatomy and disease processes. I feel that this area would be a major benefit to a coder in any specialty. Thank you.
I am the owner of a billing company and I employ 3 full time billers 2 are CPCs including myself. Our clients select their own CPT codes and provide either the ICD codes or a written discription which we then code. I encourage "clean claims" meaning we take the time to review the codes before submission for accurate coding and also reimbursement rules such as bundling. I encourage education and try to provide my staff all opportunities including manuals, software and seminars. We pride ourselves in taking advantage of all technology available from payers and our billing software; this has made us much more efficient and able to provide excellent service to our clients.
Working in a billing service I have multiple practices assigned to me. I have one practice that the office and physician are "spot on." Codes, documention etc are correct. They expect me to review and check their work. Other accounts use the check lists. I have other accounts that send all of the documentation and am expected to code from their documentation> (they make no attempt to assign codes). Some physicians are open to discussion on coding issues. Some listen to me with no reaction and then others dread any discussions.
I enjoy being self employed as a consultant, however, benefits and steady work is an advantage in being employed by others.
Our organization is new to provider-based billing so have run into many issues. We have a good overall staff and professionals to "go to" for coding questions. I personally have 25+ years of coding but find there is always something new coming along, whether "good or bad".
Coding is spreading into other areas outside the hospitals and practices. It is important for coders to understand that their credentials and experience will be of great benefit to payers and auditing companies. Good coding ethics are highly valued.
In the hospital there are only 3 CPCs. All coding is done by Medical Records, which is where the other two CPCs are located. the other coder's in M.R. are not certified but do an ok job, as always there are corrections that are done but overall they do a pretty good job. I work in the pt accting dept & handle all coding errors & help the billing/Follow-up depts w/all coding issues for all area's & specialities. I hold the position of compliance analyst.
My providers use a system called AHLTA this well code for them, however unless the provider knows how to change the codes it well code wrong. So it's almost like coding from the being for the coders. But it is a great help with education with the providers on coding.
Generally speaking coders are set up for success and there are plenty of resources available and coding educators to rely on. Salaries are kept at fair market value for the area.
Our large multi-specialty organization is in the process of implementing an Electronic Medical Record (TouchWorks) and my job is training the providers and staff how to use it. There are a lot of helpful coding areas in the application and it has really increased the accuracy level of documentation for patient visits.
Surgical, academic practice. Coders code procedures, physicians code EM.
My work environment is not a typical setting. I code for a teleradiology group.
We have several coders in our practice yet they have to code at least 5 charts within a year plus work their regular job which is receptionist staff to managers.I would like to know if a practice benefits more from having a coding Team who has the main job of just coding or like we do our coding. CPC class is offered when you pass the test then you are to pick 5 doctors who you would like to audit within the year. You look at their schedule make arrangements with that Health Center and go out and audit when the provider is seeing the patients then at the end of the day go over the audit with that provider.Some providers like this and others do not.
I am a coding review nurse for a large third party payor. It is difficult for me to answer most of the questions on this survey because they seem to pertain to physician practices.
I am a traveling consultant working at different locations for a special project at different facilities. I am abstracting for the clinics to go live for a paperless office.
When I was first hired where I work I did audits of the physicians coding especially E/M. We have different administration and they do not want me to audit at this time. They initially, with the administration change, had somebody doing coding responsibilities that was not certified. The person has since obtained her CPC. It is for this reason that I pay for my dues and CEUs and keep them current. There is currently a hiring freeze due to the state's financial situation but I am hopefully to be able to use my coding knowledge at some point in time before I retire.
I supervise 16 coders who do roughly 75% coding audits prior to claim drop. Primarily, we provide coding support for Family Practice, Internal Medicine, General Surgery, Pulmonary Medicine, Infectious Diseases, Oncology, Urology and Wound Care, coding E&M visits and procedures. We have four external audits performed annually. Our ICD-9 coding is at the 98% accuracy range, and the E&M/Procedure coding is at the 80% range, which we strive to improve. Several practices have recently implemented the EMR, which has affected the way in which the data is documented, but of course, the coding rules have not changed. This has presented some challenges, but we are continually working to ensure our EMR documentation will stand up to an audit.
My orthopaedic practice closed 12/06 and am now working for an IPA working appeals and claims problems for provider members. My coding experience has helped a great deal with this new position. Am learning a lot outside of orthopaedics.
I am the supervisor of coding and billing and the only CPC in general pediatrics. My other 2 coders are encouraged to complete a comprehensive class and encouraged to take the CPC exam. Both do qualify to take the exam for cpc-a
Physicians are not credentialed as a CPC, CCS or any variation thereof. I am worried we are not compliant. I often perform higher level coding to satisfy departmental needs.
Very nice work enviroment unless you have to deal with disgruntled or frustrated providers.
I am in Warren County PA and coding is a very difficult sell, but I am working on implementations.
I would like to see a discussion regarding the knowledge and decision making capabilities (by law) that a CPC and other creditialed coders possess. I would like clarification how a CPC education and capabilities align with the Department of Labor/Federal Register description of exempt and nonexempt from overtime. There are clear guidelines in the Federal Register. The question is; Can and Do coders make coding decisions that impact the institution that they work for? Do we coders perform a higher level of decision making? Do coders simply educated themselves on the industry standards and apply them to the medical cases that they are presented with? If I were to say that my auditing a chart, I am making discretionary decisions, or am I using the knowledge of the industry standards? Aren't all discretionary decisions made by the medical professionals and we change thier words into neumeric codes for the insurance company to understand? As a coder you feel prestige with your position, however are we not really "clerical in nature"? This would be a great topic to address in the Cutting Edge. In my last two positions as a CPC, I have witnessed that the established coders "have been doing this for years and we are getting paid" I fresh set of eyes, will pick up on "coding habits" that do not align with current-fresh and optimistic views for change. I would like for Institutions such as hospitals to recognize CPCs as they would a RHIT. In this setting we perform the same duties, however the benefits and wages are clearly non compatible. My current employer has a list of "hard to fill" positions. If your refer a new employee there is a $500 bonus, if the employee is still employeed after a period of time, the employee receives a bonus as well. The position is titled "Certified Medical Record Coder", however when someone tries to claim the bonus, the denial of the bonus is "RHIT only" An article for Cutting Edge that address the differences/simularities between the two designations would be beneficial to someone that is gain recognition for the CPC. Thank you for hearing my concerns.
We're a teaching institution and are usually short-staffed when it comes to coders. It can be very hard to balance productivity with accuracy. We don't have a good internal process for questions. We have lots of knowledge here, but no group to send questions to, only one individual. The wait time for an answer can be very long.
There needs to be more checking of accuracy for coding and auditing. We havent implemented that yet.
Last year I had to spend all out of pocket, this year there is a new system to assist with CEUs. There are 6 coders to over 100 billers a few of the billers, have done some coding and a few are certified. All coders have to be certified. I think our salary is very poor for the work we do and the level of accuracy that we provide.
My position and department are not "heads down" coders. We are the revenue cycle department for a hospital network and handle the CDM and assure all necessary tools are in place for capturing coding/charging as accurately as possible.
We do mostly audit and some billable. We code charts for the Navy.
I just started with this Hospital Based Rural Health Clinic and am trying to implement and change a lot of the billing and coding process within the clinic. I answered all the above questions as to what I see was happening in the clinic before I came here.
To be hired as a coder, experience is a must at the company I work for, otherwise they will not consider you for a coder position.
I spend a lot of time looking at charts because the provider forgets to put ICD-9 code and CPT codes on encounter forms.
You asked the environment I worked in...which is payer but then the questions really were not interested in or geared towards coders that work anywhere BUT a practice environment, that's too bad you are not interested in us, the coders that work at the payer level.
I work in Ob-Gyn and have a hard time keeping up with the charges for 18 Ob-gyn Physicians. As well as coding,we have to enter the charges also. This is what is time consuming when someone uncertified could do so I could spend more of my time coding.
I provide education to 3 departments that I code the procedures from on how to enter the charges to capture our correct money and stay compliant. I have had seminars in these departments and anserwed Tech questions on what to charge. I have also had a hand in the helping to develop the charge tickets that are turned into the department for billing.
I work for a large health insurer . I also teach medical coding to adult learners. I believe a survey should include questions not related to a physician practice. I am responsible for professional provider reimbursement for all of WV and contiguous counties
I feel that Managers of coders should be certified in all aspects of coding. o They are not helpful if the coder has to train the manager or has no one to bounce issues or questions off of. My boss is not a certified coder. He has a RHIA something like that
I work in a small business office with two other certified coders and a certified supervisor. Our workload is heavy at times however my time is split between coding for reimbursement and auditing E&M visits.
I am employed by a HMO. I assist our claims department with coding issues, implement fee schedules, keep abreast of regulatory changes, ensure that new CPT, HCPCS, modifiers and ICD-9-CM codes are entered into the system and term the deleted codes each year. Assist our external provider representatives with coding issues and assist with provider education, assist the Medical Director with coding issues. Assist with creating and updating our Medical Payment Policies. Involved in a Claims Coding Workgroup that meets regularly with local hosipitals and payers to identify and find resolutions to billing and payment issues.
We have 200 plus MDs. They are all different.
I am the only coder for 4 doctors,they do some of their own coding but I always go over it to check that it is correct.
I work in Clinical Editing Disputes. I review retrospective denials per provider office written request along with medical records. I only review our coding software's (ClaimCheck by McKesson) denials. I review all different specialties and when I am unsure if I should uphold a denial or to allow it separately, I ask one of my Medical Directors/contractor MDs.
Extremely important to outpatient billing and hospital based clinic billing.
I work for an orthopedic practice where the physicians do all the coding. I have one physician who will bring me his surgery charges to code. Most of our physicians have been in practice for over 10 years and since they continually do the same procedures, they are pretty accurate on their coding. The E/M coding for our practice varies by physician. We have a compliance manager but she and our billing dept do not work together. I really have no idea what she does. Over all I think we code to a 85 - 90% accurate rate.
I work for a billing company of over 100 physicians. They have a billing sheet with the most common codes and the PCP offices have a list of their most common used ICD-9 codes. We as coders, review these sheets each year and update them with any new codes or corrections. Our hospital based physicians do their own coding but some of them don't get billing to the 4th or 5th digit, then the coders are expected to correct these. We also keep our physicians updated on any changes or documentation requirements needed from them.
I believe my job/role in my career is an important one. Although I do not feel I am treated as though my role is as important as it really is I still strive to be as accuarate and productive as possible.
We are very micro-managed in my office, and unfortunately my manager is not certified in coding, nor does she know anything about CPT at all. It is assumed by management that the physicians should automatically know their CPT coding, therefore we as coders are heard last, not first, much of the time, even though we correct much of the physician coding. I would like to have a more positive influential role in coding in my office; however no one wants to "give up the reins", therefore coding tends to be a stagnant field in my office. Outside educational opportunities are all but banned; definitely not encouraged.
We don't get much appreciation for our work, and the demands to code more charts faster are discouraging when we're doing the best we can
I do not think I use my knowledge of coding as much as I could. I would love a job that I could do that at. Our physicians are pretty well informed when it comes to coding and that makes my job a lot easier. But their surgeries are what I watch mostly.
I am a billing department manager. I can appreciate a certified coder because I am one, but what I look for in an employee is someone who understands the entire revenue cycle. When hiring, an experience biller is important, one being certified is an added plus or perhaps one that is considering certification because surgical coding would be another task that they could perform once they show that they understand the process of coding from an operative note. If one is willing to learn coding on the job then obtaining their certification would be an asset. I do not approve of becoming a certified coder to learn to code. I think certification should verify what you already do is being done correctly, but that opinion comes from being in this business for many years and working my up from an insurance clerk to a coder, a process started due to the natural progression of coding being required for insurance pre-authorizations. That's how I began to learn coding. As as aside, the Project Xtern program is great, and when I re-sign up for that program my plan is to have who ever I acquire start working with denied claims, working the EOBs; understanding coding goes a long way with that task.
Some providers easier to work with and accept direction better than others. Our newest physician's friends told him how lucky he is to go to a practice where coders select all inpt and op coding all doctors pick is E/M CPT code levels for office services. Coders do the rest. More problems with software lately, since NPI changes. Hope that is better soon.
My job is to educate students in the rules, regulations, and coding policies. I encourage each student to explore the changes in our industry to keep current. I also work with externship placement and doctor's offices. There is opportunity available here to help educate the physician in policy changes and regulation requirements. Most offices are encouraged by the level of understanding the students have and I have heard the students sharing their knowlege with their extern sites.
We wish we could have many clients for Coding.
The billing company I work for has a large variety of specialties and facilities. We are expected to know it all. It can be very frustrating and stressful.
I have worked as instructor- the university had tried without success to have formal training for the residency program (incorporated) while I was there the physician's did do some rotations with me and attended seminars I had presented - SAD the buisness end was seperate from the university - They seperated the coders from the physcians that was after I had left. I now work as an auditor - HCC Risk Management - I was really surprised to see how much I did not know about Mmedicare compliance rules regarding some of the documentation requirements. Physicians are always eager to improve - but at the same time are scared of any type of audit.
We are an extremely large physician practice based out of a large hospital and many external offices. We do the coding for the outpatient and inpatient services that are provided as well as the billing for the facility services.
We have just opened and I have not yet started doing any coding and have not yet worked with any of the physicians.
I have realized that the definition for coder, coding, biller and billing are interpreted very differently. Duties can vary from extracting codes, to data entry of charges or payments.
I code all emergency room records and outpatient charts. In addition I am the Medicare compliance coder, obtaining ABNs when necessary.
I work for a large billing entity responsible for 90% of the hospital based teaching hospital physicians who the physicians are in short forced to use. The billing entity's goal seems to have changed from practice management/physician billing support to revenue cycle services only: to automate coding such that the coding burdon is on the physian with a % of QA performed to increase productivity profit margin/reduce the coding workforce/cost - but the physicians are not directly aware of the change in the level of service, responsibility and liability.
I recently moved to a smaller hospital environment where I am responsible for more of the financial aspects of further education. However, there are other benefits and more freedoms. I can learn whatever I wish to learn in any area I'm interested in. This is much more important to me.
Having 28 total clinicians and an audit program that requires baseline and biannual audits, along with credentialing with the payors presents challenges of managing time and resourses. Finding time for continuing education, not to mention the financial burden of such when working for an hourly wage for a community health clinic is also a great concern.
I work for a hospital that has purchased numerous local practices. The Physician Services Coders are housed together in an area where each coder has a cubicle. While the cubicles could be a little larger, the environment is bright and airy. Noise is sometimes a problem but rarely causes an intrusion or distraction. Temperature is fairly well controlled. Depending on practice size and average patient load, coders have from 2 to 3 practices each (upwards of 8 to 10 providers). Dx codes are assigned by the coders based on the dictation. Each coder has access to computer-based CPT, ICD-9 data (some prefer to use books), and the transcribed notes of a visit. EMR is being introduced. Coders must visit each of their assigned practices 2-4 times per year. More often if needed or if the providers request a visit. After each outside independent audit, the practice's assigned coder must visit the practice to debrief the providers on the results of the audit (2 per year). The work schedule is somewhat flexible - as long as you do your 40 hours, you can come and go as you see fit.
I am the only coder in my office. I code claims, review charts, enter charges, bill insurance, post payments, collect money from patients and insurance companies, appeal all denied charges when applicable, and also do a lot of W/C approvals for specialists and referrals. And if I have time then I get to try to earn CEUs and review coding changes.
My job is to make sure that everything that is billed to the insurance company is documented,correct coding,I do the billing, dowload reports from the clearing house to make sure all claims went through, i work with denials,which few of them are coding errors, most of the time these are billing errors( incorrect ID numbers, policy terminated). I send medical records when requested. We have self pay patients,therefore I do the adjustments for any discount given by the doctor.I send statements to the patients. I deal with credentialing and sometimes I help with the front desk.
Proper coding is the key to compliance and with compliance you will see higher reimbursement and fewer denials. Extensive knowlege of correct coding in my practice helps me correct any coding problems and help my physicians achieve their goals.
I work closely with the doctors. I'm in charge of creating spreadhsheets and tracking E/M codes used by providers to insure accuracy.
This is my first year to be a CPC... Our office expects the billing department to correct all billing mistakes, from coding to the improper loading of ins, we do often need to look up progess notes for missing ICD-9 and CPT codes and provide on the minute coding changes and correct coding advise, Some of our providers only want to treat patients and leaving the billing to someone else. We have direct interaction with all employees from front checkin and checkout staff, to MA and nurse regarding loading ins, coding services correctly, frequency, provider specific scheduling (non-physician providers, and compliance of contracts and care given to our pt's. Even though we work with an encounter form with frequent ICD-9 and CPT codes performed and treated in our office 15-20% are incomplete or total left empty daily. Billing and coding positions should not be filled in any practice with some just wanting to earn a paycheck as this position requires ongoing training and education that requires motivation, dedication and above all else accuracy.
I am the billing manager for the practice. We have an electronic medical record system that is linked to the practice management system. The doctors have worked very hard towards there goal of being able to code there own charges and improve the quality of the documentation. My job is to audit there work while creating the claims and monitor the accounts receivable and follow with claim rejects. I also keep up to date with the payors update and changes as well as maintaining an ongoing fee schedule for each payor. I have to say that my recent experience of changing from paper charts to electronic charts has been a demanding one. Depending on the system that is being used, it can be very easy for the doctors and/or nurses to enter incorrect information and it not be detected. It is very important to also audit this as well as the coding accuracy.
I am a Manager of Health Information Management for a Home Health Agency. I have two coders under me, and about to hire another one.
I am the only coder in a group practice which has never had a coder before. I get some push back from some of the physicians because they do not see the need for an on staff professional coder.
Our office is a multi-physician clinic with lab/radiology/nuclear med/ultrasound/IV therapy. We are two coders who process everything doing minimal 50 thousand a day! we have constant interaction from the patients because we collect money also! we use to make all follow-up appts and had review help for billing claims from our supervisor. Who doesnt see guidelines the same way we do. we have made the office more money because of our knowledge and how to effectively bill. we are beginning to treated like we really know what we are doing. We have worked here eight years coding! Our doctor's listen to us it is management that seems to not comprehend at times.
I work for a large Cardiology group, 17 doctors. I'm the only CPC coder for both hospital and office charges. We have a girl in billing that has some knowledge of coding, but most of the coding is left to me. I'm salaried and for 45 - 50 hours a week.
My position is administrative; I also have accounting duties; I no longer supervising our coding department, but I maintain my credentials because I assist with insurance appeals and assist the coding department when needed. I also serve as a mentor to our new coding supervisor. Our current administrator is extremely supportive of our coders and has helped foster a sense of trust between them and our physicians. I feel that administrative support is essential to successful physician relations. Our practice is multi-specialty; our coders review encounter forms before billing is done, with the exception of 3 specialty offices.
I work for a Navy Medical Center so insurance filing and EOBs are treated differently than in civilian practices. Also, the software the practice uses generally applies the E&M codes.
I also do the surgical pre-authorizations for Blue Cross and Blue Shield
The coding work is from a clinical laboratory perspective. We perform many internal billing, compliance coding audits within our organization. I am interested in every aspect of coding although I do not have an direct opportunity to utilize these skills.
I am unable to fully accomplish correctly every week the amount of work that is necessary for this job. I am in charge of coding, billing, etc etc for four doctors and have staff that is not trained, except by me when I am privy to the problem. Doctor is unwilling to hire trained personnel, as he does not feel that that is necessary if one or two of us can train the rest. It would be wonderful if every employee had to be trained to a certain level in coding and billing requirements before they can be employed in a a medical practice by law. Until then, the physicians income will be suffering in the long run, and by then it will be too late.
My work relationships are a bit different from the norm, because I am a health care fraud investigator, therefore most of these questions did not really apply.
I am a new certified coder in the central business office and I review other coder's work to determine correctness on accounts that are hitting billing edits or denials. I am often asked to code interventional radiology procedures and cardiac catheterization procedures but my employer does not want to pay for education to train me in these areas.
With the decrease in reimbursement & the increase in patient load, our budget does not enable us to have enough staff to cover PTO time. Therefore, many are multi-taskers and must leave their tasks to pile up in order to cover another position as staff is needed. This makes working in the medical industry increasingly more difficult, burdensome and tiring. Thus, I feel that valued employees reach burn out much sooner & therefore create additional staffing needs regularly. The insurance CO's and government need to quit making add'l work in this industry as eventually, there will not be the great health care we take for granted now. Leave medical up to medical professionals & get political government hinderances out of the way as well as non educated insurance Co. employees who govern our patient care. What is this world coming to? Put the patient's best interest back into the forefront of medical treatment!
I currently do coding and data entry. We have only three clinics completely on eletronic health records, staff and providers look to me for solutions with electronic health records since our CAC left for antoher job people are constatnly needing my help. We currently are working without current CPT, ICD-9 or HCPCS books and rely on 3M coding system for our codes. We have no time to attend any trainings that offer CEUs or, if allowed to go, can only go to events that are free. We are lacking people in our office, we are currently six weeks behind in entering.
Managers keeps the staff updated on coding changes and updates within our regional billing office on a regular basis also with testing and discussions.
Since I work for an independent coding company we only have a retired physician on our staff so there really is not a relationship such as an medical office staff
I have the responsibility for multiple surgical specialities and don't find experienced coders able to meet expectations. Most coders that are certified can't apply what they have learned. I have a hard time retaining coders, they are in such demand. My employer is supportive and supplies resouces, I just don't find people that have strong work ethics, they want to work from home without demonstrating the ability to understand complex cases or how to research them.
I am fortunate to own my own consulting company that offers education to small physician practices. I visit many offices and do all my administrative work from my home. It is a fulfilling position and the fact that I am certified earns me a great deal of respect.
I work in a specialty practice. Our doctors will either send a code up on our encounter forms or write the diagnosis for us to code. We do not code from their patient notes.
I work for a group of pathologists, one of the physicians is trained in CPT-4 coding and reviews the other providers use of CPT codes. I mainly do the ICD-9 coding.
We have purchased the Intelicode software for auditing, and are currently training physicians to better understand the CPT documentation guidelines. The "cheat sheets" used by our Emergency Department physicians is updated regularly with many options available, not just the ones they use most often.
We work with an electronic healthcare record so the providers are required to initially code the encounters. However, we also have CCE Coding Compliance Editor and our coders and myself(auditor) then review and make any necessary changes to the codes and send a report back to the providers notifying them of changes along with training and education notes. I audit all third party claims prior to submission and we experienced a 165% increase in reimbursement following the first year of implementation of this new process.
I code radiology and am not quite sure what the physician coders tasks are.
I am a Fraud & Abuse analyst for a fiscal agent. I conduct retrospective reviews for cost containment or identify potential fraud cases with recovery potential. I meet with the state OIG/PI department on a weekly basis and work closely with the attorney general's office on active fraud cases (that I have identified).
I have been very fortunate to have the support of a Manager who believes that certified coders are essential to the Revenue Cycle Management operations of the University. Unfortunately that is not the attitude across the board.
We have a five day bill drop, so 3 coders are always under pressure to get 120 patients a day coded for the facility; while we make sure the MD's documentation is complete, so the chart can be coded. If they are not complete then we will code them when they are.
We do a lot of work that really has nothing to do with coding, we enter recalls, scan consents and insurance cards, obtain referring physician info to include NPIs, UPINs etc, register patients that have had offsite testing, precertifications for testing. This leaves us little time to keep up on the latest rules and regulations that effect our speciality of cardiology.
I manage a group of 4 hospital coders and 5 physician coders all of whom are either cpc,ccs or rhit. with the assistance of the 2 compliance coordinators we provide reviews and education for all providers on EM and DRG coding. Physicians are responsible and expected to understand EM leveling and mark their service records appropriately. The coders review their documentation, EM codes and assign the diagnosis code (we took the ICD9 codes off the charge ticket) or they select from a pick list when ordering their tests online. Some physicians are good at it, some don't like to be told and some appreciate greatly :) some of the questions I found hard to apply just a an agree or disagree so that's why I added some further explanation
My office does not stress the importance of being certified in order to perform my duties. I also do medical records duties such as filing, requesting medical records and making patient charts. I would prefer to do more coding.
Some "agree" checked boxes would be better reflected in a "somewhat agree" check box.
I am the office manager, and coder of a family practice. We have one doctor and over 6,000 patients. Not only is reimbursement important but a lot of solo practices have to have there money in a timely manner. I have to handle all insurance claims, coding of all encounters, collection accounts, plus all the billing. That doesn't even begin to include office manager duties.
Since I code for multiple ASCs from Op notes in my job, answers to these questions are quite difficult. We don't have actual communication with the physician's whose op notes we code.
In my line of work we have to understand all areas of coding and not just focus on one specialty...we configure and map software for our company, so that when a provider sends claim in the system will know how to process the claims.
We are a hospital based physician network and the hardest thing to educate is consultations. Our specialists think that all patient encounters are consults and we have a real struggle in convincing them otherwise. We use the criteria provided by Medicare but to no avail. I think more information on how to convince doctors that not all visits are consults would be very beneficial.
It has been a wonderful experience to be a coder in the facility where I am employed. There is a lot of support for education and a full library to get information on coding issues, also have 2 educators in our area. It has also been challenging in many ways.
I am the manager of a data quality department in an organization that has just rolled out the electronic health record. Physicians code their encounters, and our staff audits their work. We regularly meet with physicians regarding their documentation. We also train physicians individually and in groups.
I'm like a coder on loan to a hospital-based OB Clinic. I help the HIM dept at times assigning outpatient ancillary ICD9 codes. Otherwise, I'm more of a data entry person. Although, I am responsible to update the charge tickets & chargemaster for the clinic.
The office has one physician and one NPP. One manager/coder
we are multispecialty w/ 9 certified coders to assist and educate coding for 180+ physicians and extenders. We assures coding compliane through concurrent audits of documentation and coding work files - which the workfiles compile to our dept from different departments - reimbursement/patient accts/insurance/and credit dept. with questions they may have. We work with administration and QA as needed. We have several coding resourses available to us. Coding is built-in as part of the orientation for new employees. We create flow sheets to assist physicians and staff members. - These are a few things we do. We are salaried employees and appreciate the fact that our clinic recognizes the importance correct coding coding department. We are not front end coders. We educate the Drs. and nursing staff on correct coding.
Working for a payor, but we must be more rounded and informed than the average coder, because we audit all physician specialties.
Providers do not always listen to what we find out at seminars and through our continuing education. They want everything in writing and will not go with us to these seminars to find out the pros and cons for coding. So we are changing codes because of their not knowing what can or canot be done.
Coding for 7 different specialties sometimes makes me feel like Jack of all trades Master of none. Its difficult and stressful some days, especailly around the 15th and last day of the month.
Question 2 did not allow the answers for each question, hence the last 2 were the only ones that stayed answered.
Our doctors and PAs select the E/M levels and the CPT codes. There are 3 coders and we are all certified. However, 2 of us, myself included, are not allowed to apply E/Ms in case a doctor forgot to mark it nor can we make any changes. Only the senior coder can do that. We have yet to finish formal training on the E/Ms. I do not have any direct contact with the doctors. The irony of it all, is that while the doctors apply the E/Ms and I am not allowed to I have been told that in the end any coding done (accuracy etc.) lies on the shoulders of the coder! This really puts me in a bind. Who knows how many charges have gone out the door without the right E/M levels? We spend our time reviewing the charts, checking to see if the procedure code is correct and changing the procedure codes if they are incorrect. Then we transfer that information onto another paper. The documentation at times is poor to begin with. It's almost like doing double the work all the way around. Also, the medical director has made decisions that I'm not comfortable with as far as coding goes but our operations director says we have to follow them.
One cannot answer the questions 2 & 6 as only one check is allowed in each column byt the question/answer screen, if i put a check in the same column when answering a diferent section of the respective question the screen removes my check from the previous part of the question, it NEEDS correcting!!!!
I truly feel blessed to be in the office environment that I am in. I have support for learning everything I can about coding/compliance issues. My providers are truly happy that someone is looking out for their best interests.
I could not complete the survey, when I mark the boxes the upper marks get deleted
100% of my job is payment reimbursement.
I was not able to answer all the questions. I checked an answer and the system erased it when I went on to the next question. Very informative survey.
Are you asking when it is done by the surgeon/physician or when it is done by the coding staff?
WOULD LOVE TO SHARE ANY ADDITONAL FEEDBACK KCOLLINS@ACTIONMAS.COM
Many of the N/A answers above were answered as such because the answer is "I do not know."
Second time I have been asked to complete within 2 weeks.
have lots of problem with the audio conf (lisa France)
I am the Business Manager for the practice. Our front desk enters office visits. I code all surgery. In your percentage of work, you have left out the accounting, bill paying, taxes etc. other services performed by a small practice Business Manager
I enjoy working in the health care field especially coding and I love the environment that I work in and hope that I am doing this for many years to come
My work environment is fantastic. Everyone works together and is open to questions and suggestions. Wonderful caring environment. I love my job.
Currently, I work as a Medical Record Analyst, and job security is rather shaky at the moment. Many of those above statements, do not apply. We're currently between managers and in our current department does not code, except what is written in our protocols. Projects change at a moments notice, since grant money may be shorten or cut off.
I work with Resident and our program feels very strongly that each doctor upon graduation will know how to use CPT/ICD9 and HCPCS books and available information to correctly code their visit to the correct level for valid/compliant reimbursement.
I work in Oncology Facility that has a total of 6 Oncologist and 6 Radiologist. I only do the coding of professional and chemo services peformed by the Oncologist. One of my oncologist is a Gyn/Onc and is on the Coding Committe of the ACOG and when it comes to coding his surgeries usually he is right on but there are things that occasionally he tries to include that are bundled, and i will have to remind him. My Hematologist/Oncologist knows his ICD fairly well but I feel that he always overcodes his OV's and when I have discussed this with him states he feels that the reason for the visit automatically throws into a higher level. I have never been able to convince him otherwise.
I have worked in the billing office here for eight years, taking the exam for certified professional coder two years ago. It took a while for the medical director to come around and see errors in the way he coded, but after the initial quarterly exam, I guess seeing the same problems again and again, he finally came around. Sometimes it takes persistance working with providers. They aren't perfect, but make sure you have documentation to prove everything you tell them. If you say they are undercoding, be able to show them why and how from which chart, date of service, down to the specific detail, if possible.
I am also the surgical coordinator and more than half of my time is spent on the surgical aspect of the job.
I act as office manager, coder and biller for small one man practice.
I work with several different specialties in a very large medical group and "most" of my providers welcome the input and trust the judgement of their Coders/Reviewers but there are a few that disagree and can make it rough.
My job title in this office is Billing Manager/Office Manager. We have a one doctor, busy OBGYN/Urology office and Surgical Center. We bill HCFA 1500, as well as UB92 claims for the surgical center. I am solely responsible for insurance billing, EOB posting, collections, statements and guarantor payments. I am in charge of Operative Reports, Pathology reports as well as office and surgical CPT coding, ICD-9 coding and HCPCS. The doctor does help by checking a super bill list of E/M, CPT and ICD-9 codes but does not accurately choose codes. He believes that he can choose codes to "rule out" instead of billing symptoms. My responsibilities also include daily, monthly and yearly reports, lab audits, appeals and continuous monitoring of outstanding insurance claims and medical record correspondences. It is very rare that I can tell the doctor that he is wrong about something. He thinks he knows everything! He will argue over every detail so I just do what I need to do to make sure everything is coded correctly and he doesn't really check up on me. I am the only coder in his office and I am the only certified professional in his office. He has one Medical assistant but no RN. I pay for 50% of my insurance. I can not add my husband or family to my policy, no 401K, no dental and I have to work with his wife and him both giving contradicting orders. I need a new job!!!
I work in a small facility. I work as the transcriptionist, coder and part-time pharmacy technician. It is a lot of work and I am often behind because I have too many responsibilties.
I am a CPC, Office Manager, the only person who posts payments and file insurance. I also answer phones for appts., refills, questions for our doctor and N.P. and for billing questions. We are a small office.
I work in a small office that is contracted with CMS to investigate fraud issues related to hospitals and physicians.