Outpatient Facility Coding Alert - 2007 Issue 36
PART B MYTHBUSTER: Your Audits May Be Making Your Coding Worse, Not Better
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Article Overview
This article discusses the role of auditing in medical coding and why audit quality matters for physician practices. It focuses on the kinds of knowledge an auditor should have, the use of different documentation tools and guidelines, and the importance of aligning audit methods with carrier expectations for evaluation and management and surgical services. It is intended for coders, billers, auditors, and physicians who want to better understand how audits can affect coding accuracy and provider education.
Why This Topic Matters
Improper or poorly informed audits can contribute to coding errors, including overcoding or undercoding, and may lead practices to rely on audit results that do not match payer expectations. Understanding the broad audit framework helps practices evaluate coding feedback more effectively.
What You Will Learn
- Why audit quality matters in medical coding workflows
- How auditor knowledge can affect evaluation and management review
- Why documentation guidance and carrier tools matter in audits
- What broad competencies are relevant when reviewing surgical claims
- How audit findings may be used for education and self-review
Who Should Read This
- Medical coders
- Medical billers
- Auditors
- Physician practices
- Physicians
- Clinical documentation staff
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