timurx

c/o 2012
10+ Year Member
Jun 22, 2007
104
3
Status
Medical Student
Hi All!

I'm starting my first real job after residency and need some resources on billing/coding. I've done google searches and stuff though still a bit confused just where to start. Ideally a "medical billing for idiots" course would be great.

Any specific links/resources in mind? This is geared for inpatient/hospitalist medicine.

Thanks in advance!
 

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
18,381
11,352
Status
Attending Physician
Inpatient billing/coding is pretty easy as long as you don't do procedures. I don't know of any good courses but there are plenty out there. What I did was talk to one of our coding/compliance people before I started and then after 3, 6 and 12 months on the job, asked her to review a bunch of my charts. It's good enough for me.

Thinks to keep in mind on the inpatient side:
  • Pretty much everything that's not a low-risk CP admit can be made a legit level 3 without difficulty. Set up your note templates to capture all the relevant details (4 HPI, 10 ROS, 3 Social/Family Hx, 8 exam findings and document your MDM well) and you're off to the races.
  • Bill crit care time. You don't have to do this in the ICU and it doesn't have to require a code, dropping a tube or even an actual intervention. If you get called to the bedside for a change in patient status, start the clock. 30+ min on that (not all needs to be at the bedside) and you get another 3.6 RVUs
  • Bill your procedures (if you do them) but recognize that the time it will take to do it is usually not worth it unless you've literally got nothing else to do. Obviously, if something needs to be done acutely, you're going to do it (lines, tubes if credentialed) but for the most part, the time you take setting up for, completing, cleaning up after and documenting the procedure is not worth the 3 f/u patients you could see and bill level 3 visits on. A thoracentesis will cost you an hour or more of your day and net you 1.82 wRVU, compared to the 30 minutes you could spend seeing and documenting a level 3 f/u visit (wRVU 2). Let IR do it.
The happyhospitalist blog has some good coding ideas in it. AAFP is also a decent resource.