# Hospitalist coding



## kstults (Apr 1, 2009)

I have been asked to help a group of hospitalists of 15 who work at our local hospital. They would like me to do a coding class for them (in 45 minutes). I am preparing for this but wanted to throw this out there in hopes of getting some advice. I have not spoken to any of these physicians only their office manager. I have reviewed chartnotes and reported back to them my findings a couple of months ago. They were pleased with my feedback. My feeling is that they just want to have continuity between the physicians. I would appreciate any feedback or direction. This is my first coding class to physicians therefore I do not want to leave anything out or worse yet seem unprepared. I know this is a somewhat open ended quesiton. I will provide my email address if this makes it easier to repsond. karissa@bearcreekmed.com

I really enjoy this forum! thank you for the great info 
Karissa


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## LLovett (Apr 1, 2009)

If you can get 15 hospitalist to show up and stay for 45 minutes, you will have half the battle won as far as I'm concerned! lol

Anyway, I would suggest looking over your audit results and see what it is they are doing well and where they need to improve. That way you can organize and go over the most pressing issues first so you don't run out of time. 

Another thing is be sure and point out the positive. This can make a big difference in their feelings toward you. 

Hopefully this will not be the only time you get to meet with them. It can be very nerve racking going into a room full of doctors you haven't dealt with before. You have no idea what they are like or how they will react. Just be sure and have all your ducks in a row (ie examples, guidelines, requirements, etc..) and stay positive. 

Good luck,

Laura, CPC


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## kstults (Apr 1, 2009)

Thank you for the comments. Nerve racking is a good way to put it as I am not really sure what I am walking into. Eek! I have been going over my guidelines for hospital visits and observations codes etc. and would like to give them material to leave with.
Thank you


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## ARCPC9491 (Apr 6, 2009)

I completely agree with katmryn78, great advice! especially pointing out the positives...and getting them to show up!


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## FTessaBartels (Apr 6, 2009)

*Tips*

I find that giving them little tips that are easy to remember is very helpful.

As an example: they should always ask and document whether the patient is a smoker.  Not only is this medically valuable information, but they get a bullet for social history. 

Next I'd emphasize that they should always AT LEAST comment on two systems for the ROS. (NKDA counts for allergic/immunologic system;  now they just need one more ...)

And I'd spend some time on the HPI elements - or-  *status* of 3 chronic conditions (not enough to say DM have to tell me if it's stable or exacerbated or improving)

These three "elements" are the area where we struggle most with getting to even a 99221 visit. 

My favorite response from a doctor is "well, it goes without saying that he's worse or I wouldn't be admitting him!"  Um... excuse me, doctor, but that is my point exactly, it *DOESN'T *go without saying...

Remember you are on their side. You are there to help them. They even asked for the help. I'm sure you'll go great!

F Tessa Bartels, CPC, CEMC


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## kstults (Apr 6, 2009)

Thank you so much for the great advice. I have a packet all prepared with coding tips, points of interest for certain codes, tables etc. My response back to physicians is always "if it isn't documented it didn't happen!". The more documentation I pulled together the more confident I feel. If all else fails and they ask me a question I am not completely certain about I know that I can post it!  I appreciate the feedback so much. I will let you know how it goes. 
Karissa, CPC


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