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Does anyone know anything about E/M coding for hospitalists? In our facility the hospitalists assign their E/M levels. I have been asked to audit their records. Are coders allowed to do the E/M coding for Hospitalists?
Agree with the why not. I have audited and done some coding for Hospitalists. You are probably finding that there are some coding and documentation weaknesses when they do their own coding, as well as some missed services. That is a strong argument to your CFO to do the coding.
The only other concern are the logisitcs. Probably the Hospitalists are using some kind of charge ticket or something...I've seen codes on scraps of paper, when they see the patient. And the encounter form get to billing somehow. In order to do the coding, you will need access to the medical record, and logisitics of when you do the coding will need to be worked out. But CFOs are bottom line folks, so if you can demonstrate a positive effect on revenue he should be swayed.
Hi
I have worked with Hospitalist for 3 years and they are required to assign their own levels and supply the Dx Code as well. We have been instructed not to select the initial codes for them; however, if an error was found we were able to research it, find the more appropriate code and then communicate and confirm with that Physician. Since the medical records were not readily available to the billers/coders in the office, the electronic dictation was a primary source. There was always communication involved, which made it an easier process. This particular group had approximately 40+ Physicians and they were all fairly good with using a common system or tool provided to them to submit their charges. Paper charges was not allowed only in rare cases. Everything had to be electronic. This group of Physicians attended regular Coding Support Classes to help them clear any matters as well as they received regular audits. So in this case, it tooks some years to get to this point, but the Physicians do their part daily to ensure correct codes are submitted and legible. It can be done! If something slip through and went to denials, we were able to make the appropriate corrections.
Thanks to all for response and valuable info. I am new at all of this. I am RN..but, just recently passed the CPC exam. Hardest exam I have ever taken. Coders are invaluable to a practice/organization. I absolutely love coding!
Again..thank you..thank you! I know I will be back with more ?!