Surgeons specialize because it is virtually impossible for one person to be an expert in all of the surgical subspecialties. To be competent at something, you must do it every day. For the very same reason, we require our surgical coders to focus on a surgical subspecialty. Each of our certified coders has a minimum of three years of single-specialty surgical coding experience and then must pass our very demanding proficiency test in that particular surgical coding subspecialty. Unlike the certification tests which are largely multiple choice questions, ours are actual de-identified operative reports from our medical school faculty specialists. The few who pass must demonstrate an accuracy rate of at least 95% on our ongoing random Quality Assurance/Continuous Accuracy Improvement reviews in order to continue working for The Coding Network. Compare this approach to quality to the majority of our competitors, both domestic and offshore in third- world countries; their business model is to offer would-be coders a vocational “trade school” experience designed to prepare them for the certification test. Once they pass, these newly certified green coders are assigned to code for you. Its the equivalent of having an intern perform brain surgery!
Many surgeons will tell you that “nobody knows better than me what I did in the operating room…. so nobody can code it better than me” The first part of that sentence is correct, but does not logically lead to the correct conclusion. Coding is dynamic; does that surgeon know that just the 2010 NCCI data set includes 24,060 new active pairs and 19,083terminated pairs (237 were terminated retroactively to 1/1/09) and 869 modifier changes, and 5,299 swapped pairs? That doesn’t even touch the thousands of annual and quarterly changes to the CPT and ICD-9 coding systems. Precise surgical coding requires a substantial time commitment to learn the rules, edits, surgical coding regulations, and documentation requirements. It is not the intuitive experience many surgeons believe it to be. Like surgery, it is a career of its own.
Surgical Coding Background
- Directed by a nationally known surgical coding expert.
- Decades of experience in surgical coding for academic and private surgical subspecialty practices.
- Team of certified surgical coders each with a focus on particular surgical specialties.
- Experience in coding for surgeons in 49 states and at 60 medical schools.
Surgical Coding Need
- Well trained surgical specialty coders are difficult to find, expensive to recruit, and their ongoing training can be quite costly.
- Few certified coders have the extensive surgical coding experience and specialty knowledge possessed by The Coding Network’s staff of surgical coding experts.
- With OIG and RAC auditors targeting surgeons, there is no such thing as “a second chance” after submitting Medicare and insurance claims. They must be accurate the first time. The legal and financial risks of upcoding or undervaluation are enormous.
- Surgical specialty coding covers the most complex portion of the CPT codes and presents procedural, modifier, and diagnostic coding challenges.
- Coder turnover creates cash flow peaks and valleys.
- In smaller practices, full time certified coders are an expensive overhead item who often fill their expensive time with other less-challenging non-coding tasks.
Surgical Coding Solution
- The Coding Networks surgical coders are “black belts” at the individual subspecialty with the entire spectrum of surgical specialty coding. All of our coders live-and-work in the United States. We offer you coders specializing in:
- bariatric surgery
- cardiothoracic surgery coding,
- colo-rectal surgery coding,
- gastroenterologic endoscopy coding,
- general surgery coding,
- gynecologic surgery coding,
- gynecologic oncology surgery coding,
- neurosurgery coding,
- ophthalmology surgery coding,
- orthopaedics surgery coding,
- orthopaedic upper extremity coding,
- orthopaedic foot-and-ankle coding
- otolaryngology – head & neck surgery coding,
- pediatric surgery coding,
- plastic and reconstructive surgery coding,
- podiatric surgery coding,
- surgical oncology coding,
- transplant surgery coding,
- trauma and burn surgery coding,
- urologic surgery coding,
- open vascular surgery coding.
- endovascular surgery coding.
- peripheral vascular surgery coding.
- 2-to-3 business day coding turnaround via overnight courier, fax, or the Internet. We can dial into your electronic medical record or transcription service’s archives.
- HIPAA compliance and no documents are sent off-shore.
- Our per-case pricing model is inexpensive and our team of coders stabilizes cash flow. You only pay for what you need. Never worry about revenue cycle “whiplash” caused by absences, vacations, family leaves, etc.
- No monthly minimums gives you total control.
- Volume-driven pricing makes us an ideal ongoing solution for practices of all sizes.
- Identification and feedback of documentation deficiencies at no additional cost.
- A practical and cost-effective solution for your surgical coding needs.
- No monthly minimums.
- Temporary surgical coding to cover vacations, medical leaves and employee turnover.
- Backlog coding resolution services.
- Coding accuracy and compliance audits with user friendly and educational report formats.
- Documentation training services with subspecialty workbooks..
- Coding “helpline” services.
- OIG and RAC audit defense.
Latest Blog Posts:
In August, Ontario, Calif.- based Prime Healthcare Services paid $65 million to settle assertions it disregarded the False Claims Act by conceding patients who just required outpatient mind and participating in upcoding.
Read The Full Story […]
A Detroit-territory podiatrist was condemned to 28 months in jail today for his investment in a $1 million plan including podiatry benefits that were charged to Medicare however were never rendered.
Read The Full Story Here!