As healthcare providers continue to focus on revenue integrity this year, ensuring accurate medical coding is crucial. With the help of accurate coding, providers achieve proper reimbursement. In short, an accurately coded medical record tells a payer what illness or injury is being treated, past medical history as well as treatment provided and procedures performed.
Inaccurate medical coding leads to more denials, as well as over and underpayments thus preventing the providers from correct reimbursement. It's reported that one in seven claims are denied for various reasons but one of the most common reasons is medical coding errors. Also, medical coding requires compliance with government regulations as well as private payer policies. Inaccurate coding could cause significant challenges for a provider.
As providers move forward with their 2022 initiatives, accurate medical coding needs to be a priority. One way to do this includes outsourcing to medical coding companies such as LexiCode. We’ll detail five keys to accurate medical coding and discuss how LexiCode delivers on each one of them.
1. Medical Coding Education
Medical coding requires a vast knowledge of not only medical terminology, but also disease processes, anatomy, and physiology. This knowledge is imperative for coders to ensure they are providing the correct codes for medical conditions, diagnoses, and procedures. Since medicines and treatments continually change, ongoing education and training are vital to being successful.
With LexiCode, providers gain a dedicated team of credentialed medical coders that have access to many medical coding tools, references, and an education team. LexiCode provides the proper training and ongoing education of each coder allowing providers to focus on other aspects of the revenue cycle.
2. Staying Current on Medical Codes
Going hand in hand with education, providers need to be confident that the coders stay current on guideline changes since updates are published several times a year. Claims are often denied due to common issues including inaccurate code assignment, sequencing, or incorrect use of modifiers. Without assurance that coders are current in medical coding practices, providers are vulnerable to incorrect payments due to denial claims as well as potential compliance issues.
LexiCode participates in quarterly coding assessments and has a team of dedicated QA Analysts to ensure the coders are applying guidelines correctly. By staying up to date and using the proper coding practices, LexiCode enables providers to obtain clean claims resulting in fewer denials and appeals.
3. Proper Detailed Documentation
Documentation within the medical record becomes the source of communication between the provider and the coder. Without this documentation, coders lack the information to assign the appropriate codes reflective of the treatment and care provided. To enable accurate medical coding, providers need to make sure physicians provide detailed documentation with every patient. With the appropriate and correct documentation, medical coders can report the proper codes for accurate reimbursement.
Another way to tackle this particular issue is to provide a way for physicians and coders to communicate with one another. Therefore, coders can reach out to physicians for any clarifying information needed to provide accurate coding.
LexiCode handles this seamlessly by beginning a physician query process when the medical record doesn't contain enough detail or needs further clarification. LexiCode follows any physician query process healthcare providers currently have in place. However, if a provider does not have a query process in place, LexiCode will follow its internal corporate compliance plan to obtain all the information required to enable accurate coding. Through physician queries, physicians help clarify items that are unclear in the record which leads to a more accurate reimbursement.
LexiCode also provides consulting services to include clinical documentation improvement (CDI) support and the development of education programs for physicians. LexiCode’s education program aids physicians by training them to provide the detailed documentation needed which results in fewer coding errors and queries while providing accurate revenue within a quicker time frame.
4. Consistent Staffing
The healthcare industry faced a multitude of challenges during the beginning and throughout the pandemic as emergency room visits increased and elective surgeries decreased. During times of crisis, healthcare providers often see drastic changes in their census which affects every aspect of the organization.
Hospital volumes fluctuate on a normal basis sometimes providing coders with inconsistent work. Understaffing leads to coders rushing and possibly making mistakes, overstaffing leads to additional overhead costs and not enough work. LexiCode meets healthcare providers’ needs no matter the current census. As the census fluctuates in an organization, LexiCode scales with it ensuring that productivity remains consistent with agreed-upon quality metrics and compliance.
5. Partnering with Medical Coding Companies
Partnering with a business process outsourcing (BPO) company comes with many benefits that providers should consider. With over 40 years of experience, LexiCode provides superior medical coding services to providers of all sizes. LexiCode scales to providers' needs with quality assurance and productivity monitoring. When they utilize LexiCode, providers can expect consistent staffing, high quality, and unparalleled staffing support.
LexiCode’s partnerships with hospitals, clinics, practices, or other healthcare providers allow for continuous cash flow with timely medical coding backed by our quality assurance and educational initiatives.
