IMPROVING CODING BEHAVIORS AMONG PHYSICIANS IN A RURAL FAMILY MEDICINE RESIDENCY PROGRAM

Appropriate coding is a daunting task for new physicians just entering the world of medical practice. This is mostly due to the ever-changing standards for reimbursement, and the constant demand on provider time from an ever-growing number of patients to serve from a primary care perspective. It has been shown that family physicians lose up to 10- 20 percent of reimbursement each year because of incorrect coding. Physicians are the ones responsible for appropriately coding their work and documentation so that the clinic can be fairly reimbursed. In the East Tennessee State University Family Physicians of Bristol residency program, there is a strong tendency for most physicians to under-code the majority of office visits to a 99213, despite the fact that their documentation of these visits reflects coding at much higher levels. The goal of this project is to provide more intensive education to resident physicians on the requirements for coding, and thus change behaviors that led to continued under-coding. Researchers in this project utilized aggregate data collected in the course of the usual practice of business to show the present state of coding behaviors as broken down by resident, and then re-assessed these numbers after the presentation of more intensive education regarding appropriate coding. Education was provided in a variety of formats, including 4 short lectures at didactic sessions over the course of several months, as well as handouts for residents to keep with them at nurses’ stations containing guidelines for coding. Data analysis is currently underway. It is expected that the implementation of the educational program will have led to a statistically significant increase in appropriate coding within the clinic. This result has important implications regarding education to improve appropriate coding and reimbursement, particularly for small clinics operating in rural regions that are at the highest risk of harm from under-reimbursement due to inaccurate coding