2010 Brings Big Changes to CPT Coding in Radiology

Along with the new decade came some substantial changes to the radiology section of CPT. Twenty-eight revisions and thirty-four deletions are now in effect and must be implemented in order to receive proper reimbursement from Medicare and other third party payers.

Perhaps the most eagerly anticipated of these is the deletion of the Category III CPT codes for cardiac computed tomography (CCT) and coronary computed tomographic angiography (CCTA) procedures. They have been replaced with Category I codes and give coders four new codes to represent the procedures that were previously described by eight. Read more about important 2010 CPT changes for radiology here.

HRS Shares 30 Pearls of Wisdom for Coding Success at
AHIMA National Convention

A lot can be learned in 30 years of clinical coding! HRS celebrated its 30th birthday and shared 30 pearls of coding wisdom at the 2009 AHIMA National Convention and Exhibit in Grapevine, Texas. Held October 3 – 8, the convention proved to be a great success for HRS, attendees, AHIMA and everyone involved.

In addition to leading an educational workshop on Sunday, October 4, HRS also held in-booth roundtables on important coding topics such as ICD-10, medical necessity, pediatric coding and RAC. Thirty pearls of wisdom for coding success were shared with all. Download your FREE version here!

HIM Management Advice: What to Do When a New Hire Flops

HRS teamed up with ADVANCE for Health Information Professionals to provide HIM directors with salient advice regarding poor performance of a newly hired clinical coder. Read the entire management column online at ADVANCE.

Q: You are the supervisor of coding services for an outsourcing company. You recently hired a coder to tackle OB/GYN cases. The new hire claimed to have 5 years of experience, but after a few weeks, it's clear the coder exaggerated her skills. Her turnaround time is average, but you've found several coding errors. She claimed they were "careless mistakes," but you've seen the same errors pop up again.

Should you keep the new hire on staff? How can you address her apparent lack of experience? What can you do in the future to avoid hiring employees with disappointing performance?

A: There are several ways to handle this coder's case. First, understand where in the process mistakes are being made and develop a plan for improvement. Second, determine if the coder has expertise in another area and move her into that type of casework. Lastly, are her errors really careless? The outsource coding company may conclude she has a very modest skill set for her length of experience and terminate her employment. 

As part of ongoing quality assurance (QA), coding managers should meet with new coders one-on-one to determine the source of errors. With the level of expertise available in an outsource company, the coding manager can provide support to ensure errors aren't the result of crosswalk or other systematic issues. However, clients do not want outsource coders-in-training; outsourcing teams are expected to provide experts, not trainees. 

Did the coder represent her skills specific to OB/GYN work? Perhaps her expertise lies in other areas that are valuable to the company. If so, the company can choose to move the coder to a different set of casework within her realm of proficiency. To avoid this type of problem, outsourcing firms should always pre-screen prospective coders, check references and review 100 percent of the coding in the first weeks. For an accurate picture of the coder's breadth of work and coding expertise, pre-hire coding tests must use "real" charts that are category-specific. Despite outsourcing companies' best efforts to evaluate a coder's skill set, strengths and weaknesses are not always revealed in the testing phase. 

Another possibility is that the coder misrepresented her length of experience or expertise in OB/GYN coding, which is a larger issue. That means the coder's mistakes were not careless. No coding company should risk having a dishonest person on staff.  After top-level executive review of the situation, this new hire would probably be terminated.