Physicians specialize because it is virtually impossible for one person to be an expert in all of the specialties. To excel at something, one must do it every day. For the very same reason, we require our urology coders to focus on a just urology coding. Each of our certified urology coders has a minimum of three years of urology coding experience and then must pass our very demanding proficiency test urology coding. Unlike the basic certification tests which are largely multiple choice questions, ours are actual de-identified urologic operative reports from our medical school faculty urologists. 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 solely to prepare them for the certification test. Once they pass, these newly certified green coders are assigned to code for you. This is the equivalent of having an intern perform brain surgery!
Many urologic 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 and19,083 terminated 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. Urology coding is not the intuitive experience many urologists believe it to be. Like the practice of urology, coding is a career of its own.
Urology Coding Background
- Directed by a nationally known urology surgery coding expert.
- Decades of experience in urology coding for academic and private urology subspecialty practices.
- Team of certified urology coders.
Urology Coding Need
- Well trained urology coders are difficult to find, expensive to recruit, and their ongoing training can be quite costly.
- Few certified coders have the extensive urology coding experience and specialty knowledge possessed by The Coding Network’s staff of urology coding experts.
- The nature of urology demands seeing a preponderance of older male patients, most of whom are Medicare beneficiaries. 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. Urologists have historically been the targets of OIG and RAC audits.
- Urology coding includes 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 expensive overhead items who often fill their high-paid time with other less-challenging non-coding tasks.
Surgical Coding Solution
- The Coding Network’s urology coders are urology coding “black belts” who all live-and-work in the United States.
- 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/HITECH 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 required monthly minimum gives you total control.
- Volume-driven pricing makes us an ideal ongoing solution for urology practices of all sizes.
- Identification and feedback of documentation deficiencies at no additional cost.
- A practical and cost-effective solution for your urology coding needs.
- No monthly minimums.
- Temporary urology coding to cover vacations, medical leaves and employee turnover.
- Backlog urology coding resolution services.
- Urology coding accuracy and compliance audits with user friendly and educational report formats.
- Documentation training services with urology subspecialty workbooks..
- Urology coding “helpline” services.
- OIG and RAC audit defense.
Latest Blog Posts:
Indiana system to pay $2.9M to settle Medicaid overbilling allegations
https://www.beckershospitalreview.com/legal-regulatory-issues/indiana-system-to-pay-2-9m-to-settle-medicaid-overbilling-allegations.html Fort Wayne, Ind.-based Parkview Health System has agreed to pay $2.9 million to settle allegations it overbilled Medicaid between January 2017 and March 2021. Improper revenue codes were submitted to Medicaid for certain blood-clotting tests performed [...]
DOJ alleges Kaiser Permanente defrauded Medicare of $1 billion
Kaiser Permanente and members of its healthcare consortium defrauded Medicare of nearly $1 billion by tacking on diagnoses to patients’ medical records to earn more in reimbursement payments, the Department of Justice claims in a [...]
CMS Selects Primary Care Payment Model Participants
CMS selects primary care payment model participants According to Becker's Hospital Review, "CMS chose 916 primary care practices and 37 regional health plan partners as participants in its new payment model called Primary Care First. [...]
OIG Tags Arizona Hospital for Erroneous Billing
OIG Tags Arizona Hospital for Erroneous Billing Flagstaff (Ariz.) Medical Center failed to comply with Medicare billing requirements for three of 100 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to [...]