Practice Improvement

Documentation and coding used to be one of the most frustrating parts of my practice. How come it seems so difficult to code correctly? I can tell the difference between asthma and pneumonia. I can tell the difference between an ear infection and strep throat. Why am I unsure whether to code a 99214 or not?

For me, it is because I was taught poorly. I was trying to base my coding on whether a patient was “easy” or “hard”. Sound familiar? What I’ve learned is the coding guidelines are very straight forward. Once you understand them, there really are no more difficult decisions to make. Usually within 1 minute of talking with a patient I already know what their level of service will be.

Guess what else I learned? I was coding over half of my visits too low. When I decided to commit to changing my coding, documentation, and reimbursement, my practice has exceeded all of my expectations. Because of this I have consistently earned more than twice the national average for my specialty while working fewer hours.

I want to show you how you can achieve these same things in your practice by simply becoming more accurate with your coding. I will be hosting a workshop entitled Coding Growth Strategies, which is approved for 6 AMA PRA Category 1 Credits™ through a joint sponsorship with the University Of Oklahoma College Of Medicine.

Did you know that the average pediatric office should probably code at least 40% of their visits as 99214’s or higher? Family Medicine and Internists should code even more. At Medicare rates, if you are under-coding just 2 patients a day, you are losing over $16,000 dollars per year. Under-coding 8 patients per day (which is common in the practices we work with) means you are losing over $5,000 per month.

How would you code the following three patients?

  • Generalized dermatologic eruption
  • Fever and enteritis
  • Follow-up of stable hypertension on 2 medications

Did you know that the 2013 CPT book would characterize all three of these patients as level 4 (99214) visits? How did you code them?

Next: Patient-Centric Coding