Updated: Mar 26, 2019
If you are reading this article, you probably are a coder who has a concern about this topic. But there are some things we can do, and I want you to remember one key aspect. It is the coder's responsibility to enforce coding quality and accuracy. Yes, an encoder can make mistakes. An encoder's intelligence is artificial, thus an encoder is unable to replicate common sense, and there lies the source of a large portion of the encoder's coding errors, but don't be so quick to "breathe a sigh of relief", Coders have to do their part to remain relevant in the coding world.
#1. MASTER EVALUATION AND MANAGEMENT CODING. Evaluation and Management (E/M) Coding is the most utilized coding type by medical professionals, and ironically many coders say Evaluation and Management coding is their least preferred coding type. Notably, the auditing part. Some say It is too time-consuming, confusing and tedious. The great thing is brands like 3M, Clinterity, and EPIC have integrated E&M auditing features in their software that makes a coding E/M relatively simple, in some cases the coder has to click a simple yes or no. Then the encoder calculates the encounter and produces an auditing score then E/M code is generated. I worked at a hospital and observed the number of incorrect encoder results in one day, and I observed 30% wrong audits performed by the encoder. Wait a minute! Anyone can be trained to do that. Right? JOB SECURITY TIME......Often, auditing encoding tools are flat out wrong, because (No common sense), and it is up to the coder to apply common sense as it relates to factors such as complexity at the level of each element measured. Some software is programmed to score an encounter high as long as there where three diagnoses or more. So a nosebleed, finger splinter, and pinky toe sprain would qualify as a Level IV visit. Any certified coder know this is encounter should be straightforward or low level of complexity encounter at best. It is your job as the coding professional to point out these types of flaws. You can learn to master E/M auditing and scoring encounters at AMCI, E/M University, or you can teach yourself. Novitas as a great free interactive auditing tool as well.
#2. STAY CURRENT WITH YOUR CERTIFICATION
#3 EDUCATION IS KEY
Stay current beyond the required CEUs.
What Can you do to save your coding job? Keep your skills sharp and current. Take advantage of courses and webinars affiliated with AAPC and AHIMA . If there is an area of coding you are unfamiliar or not comfortable, there is nothing wrong with taking a course. E/M University offers courses in E/M auditing, and so too does AMCI.
Remember: You are the driver of the Encoder, it does nothing until you turn it on and engage it. Do not relinquish your power. After all, when the OIG comes knocking at the door due to improprieties in your office, who do you think they will hold accountable? That encoder does not have certification you do. If you take the wheel, master and adhere to all coding and regulatory guidelines, you also secure the longevity of your profession and its integrity.
Mrs. Jay, AMCI