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Coding for endocrinologists
A colleague once told that there are two views regarding physicians and coding: One is that coding is so important, no one but the physician should do it. The other is that coding is so important, the physician should never be the one who does it.
During our residency and fellowship training, we learn a great deal about the science of medicine. To succeed financially, however, physicians must also be adept at the business of medicine. Unfortunately, many of us enter practice unprepared for this aspect of practice. We spend years learning about patient management but are never taught about contract negotiation, office management, working with insurance companies and coding.
When I first entered practice, I had no idea what the difference was between a level 3 and a level 4 visit, between a new patient and a consult or between moderate and high-complexity decision-making. I used many lower level codes simply because this is what my peers were doing. It was only years later that I realized that I had not been coding as accurately as I could have. I am sure that I was not alone in this.
Our health care system currently rewards procedural medicine more than cognitive practice. For cognitive specialists such as endocrinologists, it is essential that we be reimbursed fairly for the intellectual work that we do. One part of this is coding accurately.
Fortunately, there are now opportunities for endocrinologists about to leave fellowship or already in practice to learn about coding. Endocrine University is an annual tradition for endocrine fellows in their final year of training. Previously the business side of running a practice was covered at this course. It is my understanding that in the future this material may be covered at a practice management session for fellows at the annual American Association of Clinical Endocrinologists meeting.
AACE also offers a fundamental and advanced course in endocrine coding along with an endocrine coder certification examination. It is open to physicians as well as their staff. On the advice of a colleague, I took these courses in 2007. I recommend these highly to clinical endocrinologists interested in improving their coding and billing skills.
Even if we delegate the work of coding to someone else, we still need to understand the documentation required to justify our charges. We must not forget that in the eyes of auditors, “If it wasn’t documented, it wasn’t done.” It is also good to look over the shoulders of our coders occasionally and offer suggestions, just as they sometimes do for us.
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