In many practices, the physician simply dictates the operative note and leaves it up to the coders to derive codes from notes typed up by the transcriptionist. But for all their expertise, coders are at a disadvantage because they don’t know what happened first-hand, Dr. Falco says. “Since only the physician knows what happened, the physician should do the coding,” he says.
Certified coders are used by Mid-Atlantic Pain, but their job is to review physicians’ coding work for accuracy. Dr. Falco says coders need to make changes in only about 2-5 percent of the physicians’ work, because physicians take coding seriously and get proper training.
Physicians train in coding
“We expect everyone to be fluent in coding,” Dr. Falco says. Physicians have to learn 100 codes, covering operations at two ASCs, two offices, a sleep lab, and diagnostics and imaging. “Physicians see coding as a very, very boring topic,” Dr. Falco admits. To make it interesting, he creates procedure “scenarios” and asks physicians to come up with the right codes for them. This is often done at the physicians’ weekly meetings.
To make sure physicians’ coding is up to par, Dr. Falco sits down with each physician once or twice a year and goes over some examples of their coding. Every two years, the practice brings in an outside auditor to review a sampling of claims. The practice has been audited by Medicare twice and “came through with flying colors,” Dr. Falco says. “We did everything right.”
Like most physicians, Dr. Falco did not learn coding in medical school or residency training. He had to pick up his expertise in coding on his own. But now, as director of a fellowship program in pain, he teaches coding to the fellows. He provides formal coding lectures as part of the curriculum. “Training in coding should be a requirement in all training programs,” he says. “This work is important.”
Related Articles on Proper Coding:
10 Ways ASC Coders Can Keep Up With Coding Rules at Little or No Cost
Blue Cross Blue Shield of North Carolina Adds On-Site Billing at Duke University Health System
Physicians Resign Over Billing Changes At Washington’s Providence Sacred Heart Medical Center
