Wiki Monitoring your Coders

[kathymoon]

I have been asked to monitor (audit) our coders (CPC), but they're not really clear about what they'd like me to check. In trying to work out a plan, I asked one of the coders if they are coding the visits and procdures or using the codes given to them by the doctors. Her response was "99% of the time we use what the doctors give us." So here's why I am confused, I audit the doctors for their documentatio and codes, then why should I also audit the CPC's. What do you do to monitor the accuracy of your coders?

Just looking for some ideas. Thanks.

 

[Pam Warren]

If your coders are not auditing the physician work, or abstracting the diagnosis codes and modifiers, then they're not really coding. Are you expected to monitor their data entry? Is there any other task that they have to make independent decisions about? Otherwise, you will continue to monitor your physicians, who (it appears) make the decisions, and the coders just post the charges.

If your coders are expected to validate the physician work, then you can monitor what they let go out the door that shouldn't have. Otherwise, I'm not sure how you can monitor anything besides what the physicians are instructing them to do.

 

[kathymoon]

Thank you Pam. That is exactly where my frustrations were coming from. I really don't think the administrators realize what a coder is supposed to do compared to our billers (data entry). I think when we met yesterday, I may have finally gotten my point across. Again, Thanks.