According to a report by CNBC in late 2014, a shortage of medical coders could reach as much as 50 percent leading into 2015. That shift is largely blamed on the industry-wide shift to ICD-10 for diagnosis coding and hospital procedural coding for all entities (providers, payers, etc.) covered under the Health Insurance Portability Accountability Act (HIPAA).
The Bureau of Labor Statistics predicts that the number of medical coders will increase by more than 20 percent in the next few years, but for those practices who are feeling the pinch, the increase in coders needs to happen more quickly than that.
Particularly with ICD-10 implementation just around the corner. Most experts agree that especially in the early days of the transition, coders using the ICD-10 code set will take about 50 percent longer than when using the ICD-9 set, primarily because of the increase in the number of codes and the greater level of specificity needed to choose the correct codes.
For some practices, a logical solution will be outsourcing their medical coding to a revenue cycle management company, like CIPROMS.
Our Indianapolis-based team of AAPC- and AHIMA-certified medical coders are experienced in emergency medicine, anesthesia, and hospitalist coding. While they currently maintain certifications in CPT-4 and ICD-9 coding, all coders on staff have begun training for ICD-10 and will be certified in the new code set as the certifying boards allow.
As you consider whether to outsource your medical coding, here are a few questions to ask.
Do you need full-service medical billing or just a stand-alone coding option?
CIPROMS offers both.
How will your outsourced coding service actually assign codes and how will that information then be entered for billing and reporting?
Our certified medical coders can assign procedure and diagnosis codes from paper charts or EMR systems, including approved access of hospital systems. Codes and other pertinent information are then entered into a spreadsheet that can be downloaded directly into our practice management system—or yours—with no additional data entry.
What happens if a code cannot be assigned based on your documentation?
Careful review of patient records allows CIPROMS to code to the highest level of documentation for maximum reimbursement. If we have questions, we return charts to providers for clarification, as well as maintaining detailed tracking of downcoded evaluation and management levels resulting from missing documentation. Our coding liaison takes it from there with customized clinical documentation improvement training—a must for ICD-10 implementation, but a common best practice for all providers all the time.
How do you know all your encounters have been coded and billed?
CIPROMS offers chart reconciliation between patient charges entered and hospital or physician logs, ensuring all of your work is converted to billable charges.
Can I still participate in Medicare’s Physician Quality Reporting System using the claims-based option?
At CIPROMS, we have been making code assignments for claims-based participation in Medicare’s Physician Quality Reporting System for years.
How can I be sure a coder has captured all my services?
CIPROMS performs routine audits and provides details reports to ensure we are carefully capturing all billable services documented in the medical record.
Don’t let the medical coder shortage slow you down, especially with ICD-10 just around the corner. Consider outsourcing your medical coding today.
— All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com. Photo by Jenna via Flickr used with permission under the Creative Commons License.
