DaVita® Medical Insights

3 Resources to Get Appropriately Paid for Your Work

Accurate coding is a key factor in optimizing appropriate reimbursement while avoiding penalties from external audits. Medicare and other payers have developed tools to compare individual physician variations from national averages, allowing them to focus their audits on physicians who have coding patterns outside the norm. Undercoding and overcoding are both serious issues and can flag an audit. During an audit the codes you have billed will be compared to the clinical documentation that was recorded in the patients’ charts.

Here are three resources designed for nephrologists to help you keep your coding as accurate as possible.

  1. Clinical Documentation Impacts with ICD-10. ICD-10 requires physicians to code with a much higher level of specificity. This resource page covers ICD-10 codes for specific conditions and requirements including renal failure, causative codes, diabetes, glomerular disease, hypertensive chronic kidney disease, anemia, adverse effects, poisonings or toxic effects, complications of care and body mass index.
  2. Coding Drop Down. Different coding documentation requirements can seem convoluted. This resource page details coding documentation requirements and gives nephrology specific examples with codes.
  3. Nephrology Coding Tips. This video playlist includes tips and tricks on coding and documentation.

In addition to reviewing these resources, consider hiring an external company to complete a coding review for your practice. The company can analyze your codes, compare them to standards and prepare suggestions to help you code accurately. Ongoing training—such as physician-specific education offered through Nephrology Practice Solutions that covers ways to improve current coding practices for accuracy to potentially reduce audit risk—is also a crucial piece of the coding review process.

Suzanne Leathers

Suzanne Leathers

Suzanne Leathers is a coding supervisor at Nephrology Practice Solutions. She has more than 11 years of experience and a RHIT certification, and is a certified ICD 10 CM/PCS trainer. She is passionate about educating practices on how they can improve their documentation, coding and billing to support the services they provide. Twitter: @LeathersSuzanne