American College of Physicians: Internal Medicine — Doctors for Adults ®

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Tips to improve coding, billing accuracy

From the January 1996 ACP Observer, copyright 1996 by the American College of Physicians.

By Deborah Gesensway

  • Do your own coding. "Creative coding" most often occurs when office staff have to reconstruct the visit from a stack of charts in order to bill for it, according to Maryann Szostak-Ricardo, president of The Ricardo Group Inc., a national practice consulting firm based in Manhattan Beach, Calif. An easy solution is for physicians to use a superbill or fee slip that already lists the physician's most frequently used CPT and ICD-9 (diagnostic) codes.
  • Keep up-to-date. Buy new CPT and ICD-9 books every year. Send your coding staff to educational programs. (See "HCFA changes rules for outpatient coding," p. 4). Read the information that comes from the carriers and make sure office staff incorporate changes into computer programs and superbills.
  • Consider electronic medical records. Computer software that can help pick codes that match the documentation in the medical record is starting to become available. Although most is still too expensive for a small practice to buy on its own, Ms. Szostak-Ricardo said IPAs and MSOs (management services organizations) are now purchasing these programs for their physicians.
  • Spot-check bills and denials. "Somebody has to double-check the office manager," Ms. Szostak-Ricardo said. "The ultimate responsibility is the physician's."

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