HCPro, JustCoding Inpatient - 2017 Issue 10 (March)
Enhancing coding accuracy through audits
March 7th, 2017
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Article Overview
This article explains why external coding audits are used to assess coding and billing practices, identify documentation and performance issues, and support ongoing improvement in ICD-10 coding operations. It is relevant to HIM leaders, coding managers, auditors, compliance staff, and facility executives who want a high-level view of audit planning, vendor selection, sample sizing, feedback, and monitoring. The article also references guidance sources and organizational considerations that influence audit programs.
Why This Topic Matters
External audits can help organizations evaluate coding quality, documentation support, and overall compliance readiness. The article is useful for teams deciding how to structure review activities and communicate results in a way that supports improvement.
Article Sections
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Why have a coding audit?
Introduces the purpose of external audits in the context of coding operations, documentation support, and broader compliance concerns. It also frames why organizations consider outside review of coding and billing practices.
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Steps to a successful external audit
Outlines major planning considerations for an external audit program, including leadership support, vendor selection, sample design, review focus, feedback, and follow-up. It emphasizes building an ongoing process rather than treating audit activity as a one-time event.
What You Will Learn
- Why organizations use external coding audits
- How audits fit into coding accuracy and compliance efforts
- What planning elements are commonly considered before an audit begins
- How results and feedback are incorporated into ongoing improvement
- What broad documentation and review issues may be surfaced during coding audits
Who Should Read This
- HIM professionals
- Coding managers
- Clinical documentation integrity staff
- Compliance teams
- Revenue cycle leaders
- Facility executives
- External auditors
- Inpatient and outpatient coders
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