Physician Coding Exercise: Here's How to Improve Physician Documentation

It's plain and simple: Improved documentation equals better pay

Help your endocrinologists understand how medical decision-making (MDM) relates to overall level of service with these two steps recommended by Curtis J. Udell, CPAR, CPC, CMPA, senior advisor at Health Care Advisors Inc. in Annandale, Va.:

1. Run a report that lists the top 20 to 30 ICD-9 codes your practice uses for primary diagnosis code assignment. Sort the list by frequency.
2. Run a secondary report that lists the top codes above in addition to the top 20 to 30 ICD-9 codes your practice uses for secondary diagnosis code assignment. Again, sort by frequency.
"The two lists help providers to target charts that represent the majority of the practice and help them to visualize patient coding by discussing common MDM scenarios and documentation elements," Udell says.

Use these lists as an education tool and discuss the level of risk involved with all ICD-9 codes on the lists to give your physicians a better idea of their MDM levels.

- Published on 2004-09-23