Productivity metrics for coding system-based inpatient and outpatient charges, including manual submissions, are consistently met based on departmental standards.
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Reviews clinical documentation to ensure that diagnosis codes assigned are accurate and makes changes as necessary. Maintains a quality metric of 96%.
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CPT/HCPCS Coding Accuracy: (a) Reviews evaluation and management codes captured by physicians to insure the codes are consistent with the clinical documentation. Uses the palmetto GBA E&M Review Checklist and Scoresheet Form to validate code capture of office visits. Makes changes as necessary. (b) Reviews charge capture of chemo services (i.e. drugs and administration) and other ancillary services (i.e. blood transfusions, etc.) for accuracy and makes changes as necessary. Translates medication dosages into billing units (quantity). Maintains a quality metric of 96%.
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Follows up with clinical staff for missing documentation or clarification of charges (i.e. missing dictation, missing charges, etc.) Maintains a positive and open line of communication with clinical staff.
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Performs assigned duties based on departmental guidelines. Daily export; assigns PD modifier as applicable per review of the census report; review Clinical Research Patient List to ensure clinical trial drugs are not billed.
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Stays current with coding policies and applies them to daily tasks. Uses reference tools to insure coding accuracy (3M, CodeCorrect, ICD-9/CPT/HCPCS manuals, etc.) Notifies management as necessary for needed coding updates to the system.
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