Surgery Center Coding Tip: Talking to Physicians About Coding Queries

If communication fails between physicians and ambulatory surgery center coders, your ASC could end up coding claims inappropriately and receiving too little or too much money for a procedure. If your ASC has no formal query process in place, independent billing consultant Lolita M. Jones, RHIA, CCS, recommends the facility’s administrators or owners sit down with physicians to discuss expectations on coding queries. Don’t wait until a payor’s auditor comes to your center and wants to know why your claims have been coded inappropriately, she says. If certain physicians are consistently failing to provide coders with feedback, they need to be warned of the potential ramifications.

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“I am starting to find that coders don’t want to deal with querying the physician,” Ms. Jones says. Some physicians may be hard to reach or cryptic about their operative report even when the coder talks to them. She says the problem usually doesn’t apply to physician-owners, who worry about the center’s bottom line and will therefore be more willing to go over inconsistencies or confusing language in the operative report. But independent physicians with privileges at the center may need extra guidance to make sure they communicate with coders effectively.

Read more coding advice:

7 Common Surgery Center Coding Errors

4 Changes to Pain Management Coding in 2011

16 Statistics on Coder Salary by Education Level

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