Wiki Coding audits done weekly

[lsmft]

In our department audits on coding are done weekly. It seems to be a lot. We all agree that audits are necessary for quality, accuracy and training purposes...but this seems excessive. If the coding supervisor disagrees with any element of a coders work a mandate is handed down to "defend your use of this code." Many of us have "defended" our selection of codes on everything from Inpatient to Outpatient and clinic encounters. One of the coders "defended" the use of a code with Coding Clinics, RAC audit information but that was not enough.

My question is simply, is this common practice or is it becoming the norm? Our department has now become a hostile work enviornment. I have always enjoyed coding but now I am beginning to wonder if I made the right choice. Are other departments in other facilities experiencing this??

 

[skiboi]

coding audits done weekly

It sounds as if you work for someone that is a Nazi, if your supervisor/lead doesn't have the confidence that the coding staff isn't capable of doing there job. He or she should be looking for a different position.
The organization that I work for performs coding audits like once or twice a year. With that being said, your denials and other forms of internal editing software should catch errors being made before they go out the door.
As far as coding selection goes and audits, who performs these coding audits?
If it were your peers then it would be more understandable, but from another person who is not a certified coder, this is ridiculous. That would certainly create a hostile work environment.
Good luck and if other coders feel this way you could try to find a solution to the problem and take your concerns/ideas forward to see what could be improved. Healthcare ever changing and improving processes and procedures!!
Jeff

 

[LeslieJ]

coding audits done weekly

Per the OIG, audits should be performed regularly. How often is "regularly"? Well, this interpretation is up for debate, isn't it, because the OIG doesn't define this term. I suppose it's one of those things meant for a company to determine for themselves.

I audit my coders monthly, but on various topics. One month it's general surgery, the next is OB, the next is Pain & so forth. I have specific criteria that needs to be met, but I don't beat up the coders for when they do something wrong.

The information found in the audits is used to find out weak coding areas that need to be looked at and then is created into some kind of training session. It can be in the form of email - and the AHA Coding Clinic is used to explain the reasoning behind diagnosis coding choices. I'll also use CPT Assistant & various society articles to explain the reasoning behind the procedure choices. It can also result in a powerpoint webinar if the topic is big and serious.

There's no need to shove the audits up my coders' noses to point out every single thing they did wrong. Most of the coders are consistently ranging between 90%-95% each month & sometimes better than that. I make sure that we're all on target. If I'm wrong, I'll back down IF they can show me. It's a learning experience, not a humiliating experience that I expect and try to give. I'm no better than any other coder, it's just that I'm experienced enough to have this job at this level. If we don't behave like a team none of us can be successful, and my company will suffer for it.

If you feel that you're being targeted and authoritative reference doesn't help your scoring, you need to take your complaints to the person over your supervisor or to H.R.. Bring your audits and bring the articles you use to defend your position and explain what's happening. It's hard for a non-coder to understand, but take the emotion out of it and help the person(s) you talk with see where/how it is that the company is affected, especially if you can point out incorrect coding on the part of your supervisor. The key is: if you're right about what you do then the materials you bring with you will pave the way better than if you're all emotional about the way the supervisor is being.

I just employed a lady who's been coding anesthesia for 7 years. That's a good amount of time to get pretty good & learn, right? This poor lady is now finding out that a lot of what she thought was right turns out to be incorrect - thanks to a very sadistic, abusive employer who valued revenue above coding correctly and bullied the coders into making the wrong choices! She is struggling very hard to unlearn the past 7 years coding errors - she's almost a brand new coder again & is very stressed out about it!! I'm not going to let her go, I'm going to build her up - she's been beaten up enough!

In my most humble of opinions, this is what all supervisors should do - but sometimes they don't. I don't know why. If talking with whoever is over your supervisor doesn't work (and there should be NO retaliation from her, either!), then you need to get your stuff & move on out of there. Find another job. Don't allow yourself to be abused or beaten up by any employer or supervisor. The damage to you is far too great, and good coders are far too valuable. I wish someone had told me this, instead of telling me to stick things out when I was faced with bully employers/supervisors. If, after discussion, things don't get better, don't hold your breath any longer, just go and tell them why in the exit interview. No, not every place you go is like this.

YOU have the power to make your own choices.

 

[vimenchaca]

coding audits done weekly

Well said, LeslieJ!

In our department, coders' work is reviewed every day by QA - but just a couple of randomly selected transactions (5). From this, the coder is provided feedback and training is provided to the department if there has been misunderstanding on any coding guidelines. Coders must keep at a 95% accuracy rate to avoid coaching/discipline, etc.

These audits also help identify misunderstandings that the medical/surgical departments and the providers may have. Educational sessions are then created and presented to the doctors. The entire organization is benefitted by these audits.

Like LeslieJ states, we are a team!

 

[lsmft]

Thank you

I appreciate the input everyone has shared. Leslie you said it best. We live in a small community and coding jobs are few and very far between. Any contact with higher management would be considered disloyal, retaliation would be swift and severe. We are not allowed to speak with other departments nor to call them.
This is a team of good and experienced coders but we are terrorized. Punitive emails abound when anyone makes the slightest infraction. What is true is that so much damage is done in settings such as this one.

The best way is out it seems.