Self-Audits: Your Audits May Be Making Your Coding Worse, Not Better

Why This Topic Matters

Audit practices can affect whether coding is validated or unintentionally distorted. Understanding the broader audit approach helps organizations use review processes to support documentation quality, provider education, and more consistent coding oversight.

Article Sections

1. Myth and reality about who can perform an audit

   Introduces the article’s central theme by contrasting a common assumption about auditing with a broader view of audit competency. It frames the discussion around the role of auditor knowledge and clinical context.

2. Documentation, guideline familiarity, and payer-specific tools

   Covers the need for familiarity with documentation standards and the possibility that different carriers use different audit approaches. It also discusses the importance of consistency between the audit method and the payer’s chosen framework.

3. Understanding evaluation and management and surgery reviews

   Addresses broader audit responsibilities across visit-based services and procedures. It emphasizes the importance of being able to review operative documentation and compile audit findings for education and follow-up.

4. Using audit results appropriately

   Concludes with guidance on how audit findings should be handled within a practice. It highlights the physician’s role in reviewing recommendations before accepting them.