52% of coders assign codes based on documentation, regardless of physician query: 5 things to know

A poll from ICD10 Monitor shows how professional coders assign codes, and it turns out physician documentation is incredibly important.

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The majority of respondents said they assign codes based on physician documentation even after querying the physician, regardless of the clinical indicators. Here are five statistics:

1. Query physician and assign codes based on physician query response and documentation regardless of clinical criteria documentation: 52 percent

2. Skip the query and assign codes based on physician documentation regardless of clinical criteria documented: 10 percent

3. Query physician but assign codes based on clinical criteria regardless of query response and physician documentation: 9 percent

4. Coding professionals do their own coding: 2 percent

5. Skip the query and assign codes based on clinical criteria regardless of physician documentation: 1 percent

The article’s author called for official auditing guidelines and for those guidelines to be made public.

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