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The Smart Rev Cycle Blog

Doctors code correctly 48% of the time

I cannot tell you how many times I’ve heard, “I didn’t go to medical school to be a coder!” Correct coding is essential for accurate and complete reimbursement, and at the same time, coding is complicated. Different payers want the same clinical procedure coded differently according to their requirements, which are always subject to change. It is no wonder that most physicians gladly hand the coding task over to back-office employees.

Unfortunately, an unintended consequence of Meaningful Use is that many physicians spend much of their time documenting in their EHR to generate charge data that can eventually be submitted as claims to third party payers.

To add insult to injury, most practices find their coders spend as much if not more time reviewing physician charge data created by the EHR as they did before Meaningful Use.

Did you know that, on average, coders make changes on 52% of encounters? That means that doctors get it right nearly 50% of the time. That also means that almost half of all coders’ time is wasted looking for problems rather than fixing problems.

Do you know how many encounters your coders have to fix for each doctor? What types of changes do they make most frequently? Being able to answer these questions is the first step towards a radically more productive coding team.