4 Motivators for Sticking to the Coding Straight and Narrow

Mon, May 8, 2017 --

Compliance, My Career

Compliant coding is worth the effort!

If you ever take the “throw everything out there and see what sticks” approach to coding, it’s time to rethink that strategy. Carefully choosing the wrong codes to bring in more money is no way to code either. Next time you need inspiration to steer clear of these methods, reach for these four reasons coding correctly really is worth the effort.

1. ‘Them’s the Rules’

Choose any code set or a payer, and it likely won’t take you long to find a rule saying that you must assign a code based on what the documentation supports and what the reporting guidelines require. Simply put, a big part of being good at our chosen profession is following the rules.

For instance, if you’re looking at a close-but-not-quite procedure code, remind yourself that the Introduction to the AMA CPT® manual states, “Do not select a CPT® code that merely approximates the service provided.”

And if you find yourself considering a questionable choice and thinking, “It’s not like I’m masterminding a $50 million healthcare fraud scheme,” take a pause. Reassess to ensure your coding complies with the rules. Your career and even your finances and freedom could depend on it.

2. Face Audits Stress-Free (OK, With Less Stress)

Putting in the effort to make each claim accurate will do a lot to boost your confidence if a payer chooses you for an audit. If your services are medically necessary, the documentation supports that, and the coding matches the documentation, an audit should go fairly smoothly. You’ll know that you haven’t done anything intentionally that could put you and your team at risk.

3. Your Future Self Will Thank You

When you submit clean claims, you reduce denials which is good for at least two reasons (in addition to the audit benefits above). One is that you won’t have to go through all the time and energy required for rework and appeals. Another is that you won’t risk losing money by letting denials slide.

It also doesn’t hurt that with every little bit of research you do for one claim, you’ll reap the benefits of that research when similar cases come up in the future.

4. Get the Nickname Captain Accuracy

Doing the hard work day in and day out does get noticed. You’ll help your career and future advancement opportunities by getting a reputation for understanding complex coding rules and payer requirements. Never forget how important you are to your organization’s financial health and compliance.

How About You?

Do you ever have those moments where you wonder if keeping up with coding rules is worth it? What do you do to power through? How do you make keeping up with rule changes easier?

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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