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Coding Improvement Module

Coding properly is an important part of any physician practice. This module presents a simple yet systematic methodology for first assessing the appropriateness of current coding and then undertaking an on-going improvement process designed to optimize future coding. At each stage relevant PMC coding resources and tools are incorporated as direct links. Follow these easy steps to improved coding:

  1. Enter your Evaluation and Management (E/M) coding data into the Coding Assessment Tool (login required) to determine how your coding patterns compare to the national Medicare averages for other internal medicine physicians. While not a measure of coding accuracy, this assessment can quickly highlight any variances that might be a red flag to an auditor or be a sign of routine under-coding, a pattern that can erode your income. Because E/M services account for a very high percentage of general internal medicine services, they are a good barometer of coding patterns.

  2. After determining how you compare to your peers, conduct an in-house coding audit (see “How to Complete a Coding Audit”) to investigate any variances from the norm and to assess the accuracy of your current coding. Carefully compile a list of the key problems identified by the audit so you can work on improving them in the future. If you think the audit results suggest a need to study the fundamentals of coding, download our guide: “Coding for Internists: The Basics” (login required) and listen to a presentation "Coding Basics: Getting Paid for What You Do" (login required) including case examples narrated by a coding expert.

  3. As a daily aide to coding future patient encounters use PMC’s two coding reference sheets: “Commonly Used ID-9 codes” and “Evaluation and Management Service Codes…”.These sheets may be printed directly from the webpage or ordered in more durable laminated form from ACP customer service by calling: 800-523-1546, ext. 2600. Carry or place copies in your exam rooms for easy reference.

  4. Periodically repeat the coding audit (step 2 above) to monitor your improvement progress. Audit frequency should be guided by the severity of any identified problems and your success in correcting them. Some practices initially conduct abbreviated sample audits on a weekly basis until improvement is evident and then gradually move to regular quarterly audits.

    Most practices should incorporate quarterly audits into the on-going routine of their operations to avoid slippage, to assure that new physicians are learning to code appropriately, and to stay current with coding changes.

Have questions about the new ABIM MOC Program?

Have questions about the new ABIM MOC Program?

ACP explains the ABIM requirements and offers many free solutions to earn MOC points.

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