Wiki New CPC desperately needing advice on how to deal with this

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tori_ryan24

tori_ryan24

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HI Forum, I am looking for some general opinions. I have a DR I work for who is completely adamant abt only using non specific codes. He is a general surgeon (whom is 70) and states that this the "best way" in his words not mine for sure.

Whenever I attempt to express the rules of coding they become extremely offensive and school me on how they get their coding logic from another coder (who they are friends with and is 70 also and still working) They are also convinced that ICD 10 will NEVER happen and that unspecified codes is the only way to get reimbursed.

Now I need my job because we all have to work so quitting is not an option. But if I change things they change it back and get upset with me. I feel at times that I am not keeping my oath as a coder to follow those guidelines because they keep me so restrained. It is hard to not argue though what I know is fact and have it in print to back it up.

I just need some strategies, something. Where we live is so small that work is very hard to find and I am currently looking but in the meantime, I just need some coping skills something to help me deal with something so frustrating.

Desperately Seeking Coding Advice...........[/SIZE]:confused:
 
That is truly a shame. But ICD-10 CM will happen and I hope it does not catch them off guard. The bigger issue here though is that this is the patient's diagnosis not the physician's. You have a responsibility to the patient to be as accurate as possible in the assignment of the code for their dx. Also you may need to watch the reimbursements as many payers do not pay claims that use non specific codes.
 
Debra, I have expressed that to them. They are just being extremely stubborn. I have never had this kind of "tug a war" scenario with this like recently. It is truly challenging me. I looking for other work though. I think that is the best way I am ever going to be the successful beneficial coder that I know I am.
 
stubborn doc

I would be concerned that there is a hi probability of possible audits and fines from insurance payers or cms Medicare. We can assume that he is aware medicine and healthcare have changed dramatically in the past 50 years. He will probably retire within the next 10 year's. Good luck on this daunting quest
Linda
 
unspec codes

hi, I am a "seasoned" coder. does your Dr. still have admitting privileges @ a hospital? If so check with them to see if they are having problems. otherwise, continue to look for work elsewhere. I also suggest keeping a log for yourself. When an insurance company begins recoupment, post payment review or audit you will at least have a record. keep your chin up
 
Run as fast as you can. This is a no win situation and no way to start a new career. Make any notes or documention you can regarding claims you have sent out to this point. As for your personal files make notes of conversations regarding coding education you have attempted keep file outside of office but do not take or copy any patient files or medical records or anything that will put you in jeopardy of a HIPPA violation.

When the audits starts and they will you will be the one under the bus. Think about it who will he blame himself or the new coder? He will be looked at as if at no fault since he has been in practice forever and never had an audit before.
Your name is attached to that claim and you have sent it off implying it is correct. He may be fined and lose the ability to participate with certain insurance companies but after 50 years in practice do you think he will care? You can also be fined can you afford $2,500, 25,00, or $250,00? Can you also afford to lose your certification because that is what will happen.

Take this as a learning experience and move on before you really regret it.
Remember also no matter what be professional when you give notice keep your cool and be polite. Simply say you have just completed an intense course and are proud to be a CPC and you feel you are limited in your ability to use your skills and knowledge you worked hard to achieve. Leave it at that. Do not burn your bridges and who knows he may respect you more and may be more open to your help. Good Luck.
 
So Grateful

I can not thank you all enough. It is very important to know that this support is here as an organization. It means so much. I though I was going to go crazy or that I was wrong.

I am desperately seeking something else. It is hard. My spouse is also Military and we are praying for orders to somewhere else so that I have more options because there is no where to go here in smallville, USA.

I have been doing the logs as far as patient charting here in office and I think that is huge. I also take steps to ensure that my documentation stands out from all the rest!!!! I think that is a huge thing.

ladies, whomever you ask for help, ask them for a little extra luck for me to get through this with my "whatever" still in tack!!!

Again, thank you, I am so appreciative!!!!:p
 
Military

Hi! I just wanted to let you know that the military hospitals are always looking for coders and a plus with you is that you are a military spouse. If you haven't already looked into it get with your jobs program on base. (you may already know this tho...) :)
 
RE: New CPC desperately needing advice on how to deal with thi

Hello tori_ryan24,
This is unfortunate that you are in a bad situation, this is one of the downfalls of being in this business and since you are a certified coder, preserving your license is most important. If you truly believe that you're in a bad situation then the best thing to do is resign before you do damage to yourself and your career. If you need to stay because you need the job then you give the surgeon the means to do damage to you at their whim and they will use you as a scapegoat when an audit comes around. Having conversations on ICD-10 and whats right and wrong in coding is a loosing battle and just makes you look like the bad person.
Look for jobs at HP and XEROX there is a need for coders and find some contract work in billing and coding.
Good Luck
 
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