Kristi Pollard, RHIT, CCS, CPC, CIRCC
What if the poor results of your last coding audit were not caused by coder error or lack of education? What if the workflow process is what needs tweaking?
Processing hospital outpatient institutional claims is complicated by the marriage of codes assigned by the coder and those from the chargemaster. This is compounded by some service lines that have complex coding rules; add in NCCI edits, and local and national billing policies and this creates a perfect storm for “”coding”” errors.
This presentation will outline the decentralized process for assembling codes and charges on a claim. In this exploration, hiccups that can impact the accuracy of submitted codes, charges, and modifiers will be uncovered and solutions will be offered to ensure clean claim submission. With a focus on departments where a frequent code/charge mismatch occurs, such as interventional radiology and the cardiac cath lab, tips for identifying, troubleshooting, and developing a sustainable workflow will be introduced.