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CODING & BILLING
er. Over-reporting of some modifiers, up-coding and other errors in
reporting the procedures performed can flag your facility for unnecessary audits. Audits can be burdensome to deal with financially and
administratively, ultimately impacting cash flow if results aren't favorable.
4 steps to a coding compliance plan
A coding compliance plan can help safeguard your facility against
these revenue pitfalls. Here are steps you can take to get a compliance plan in place:
1. Develop a policy for coding compliance. Include it in your corporate
compliance plan and have your board of directors approve it. An effective coding compliance policy addresses the number or percentage of
charts you'll audit, audit intervals, the means by which you'll audit the
charts and how you'll handle the results. Results are better aligned
with the intention of a compliance policy when an outside agent performs the audit. The coding accuracy expected from your coding staff
should be between 90% and 100%. If these expectations aren't met,
your compliance policy should outline what steps your facility will
take to get the results where they need to be. For example, you could
offer training or create policies to address problem areas.
2. Educate your staff on the compliance plan. Ensure your staff understands the importance of the compliance plan and the expectations for
accuracy. Make sure that you present the plan in a positive light and
assure them that your intention is to reduce risk while providing them
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J A N U A R Y 2013
