ICD9 codes is a nursing duty?

[superwoman27]

At our hospital they requrie all nursing staff in all departments to enter ICD9 billing codes on the patient when we admit the patient as part of our admitting process. Is this normal? We have not been trained in proper coding use so we just kind of look at the patient's health history and enter those....or whatever other illness the patient claims. I have never heard of nursing staff being required to do billing codes - do other hospitals do this?

[Sanuk]

Uh...no. So, hospitals have decided that nurse, tech, housekeeper, culinary, PT, secretary aren't enough job descriptions for its nurses and now they're going to be coders as well??? What are they thinking?

To answer your question, I have never been asked to input ICD-9 codes. Hope this doesn't catch on like other horrible, terrible, no-good ideas.

[TheCommuter, BSN, RN]

In nearly six years of nursing, I have never had to deal directly with ICD-9 billing codes. There are vocational programs for people to train to become certified medical billers and coders. Instead of adding one more duty to the nurse's endless list of tasks, your facility needs to stop being so stingy and hire someone who is specially trained to deal with ICD-9 codes.

[Kyrshamarks, BSN, RN]

I review medical bills on the side for a company, and let me tell you the wrong ICD 9 codes entered on a pt can get the facility in a lot of trouble with meficare. It can look like fraud even if it is not. I would refuse to do it.

[superwoman27]

Can we as nurses get in trouble for entering wrong ICD9 codes?

[tyvin, BSN, RN]

A small psych facility I worked at had us put them in if we did admissions or on lab requisitions. I seems the lab companies were getting miffed due to not understanding the real reason for a draw due to some nurses being very vague and not having matching Dx with draws so that's how that happened. Admissions that were done on evening or nights had to have a little something to start them off in the system but usually the ward clerk did it during days. I didn't find it that difficult due to I do MDS as well so I know how to grab that humongous book and search. I actually really like how you can pin down a diagnosis with such certainty. You get use to it.

As far as entering a wrong code; the clarity with what the system has in place is exceptional which IMO brings you to a correct Dx most of the time. I've only had difficulty a few times and when I did I asked my boss or called the doc for clarification.

[superwoman27]

A small psych facility I worked at had us put them in if we did admissions or on lab requisitions. I seems the lab companies were getting miffed due to not understanding the real reason for a draw due to some nurses being very vague and not having matching Dx with draws so that's how that happened. Admissions that were done on evening or nights had to have a little something to start them off in the system but usually the ward clerk did it during days. I didn't find it that difficult due to I do MDS as well so I know how to grab that humongous book and search. I actually really like how you can pin down a diagnosis with such certainty. You get use to it.

As far as entering a wrong code; the clarity with what the system has in place is exceptional which IMO brings you to a correct Dx most of the time. I've only had difficulty a few times and when I did I asked my boss or called the doc for clarification.

We aren't given any book to look through for these codes? For example we type in diabetes and countless different diabetes codes show up with weird abbreviations we aren't familiar with so we just pick one that seems right.

[Esme12, ASN, BSN, RN]

We aren't given any book to look through for these codes? For example we type in diabetes and countless different diabetes codes show up with weird abbreviations we aren't familiar with so we just pick one that seems right.

They will change their tune when the reimbursement changes for the worse. I would contact your state nursing board and medicare (call the fraud line) and ask them, as well as my malpractice carrier to seek advice and counsel from the lawyer.

Then I would send a letter (and I would do do by registered mail to keep a paper trail) to my manager, the director, the medical director, the chief of staff, HR, and the CEP that will state that I do not feel that I have been properly trained to code patient charts and will not accept the responsibility for any errors in coding. That I lack the proper education and training that would make this an effective part of my job. That this responsibility is carried by specially trained individuals and I am not one of them.

That I had checked with the nursing board, medicare, and malpractice insurance and although there is no law stating that I cannot fulfill the requirement placed upon me by this facility I do so under protest and with reservation. That although I have no intention to refuse the requirement placed upon me by this facility as I love and need my job. I do however, feel strongly, that I am in no way qualified to to accurately code a patients chart for reimbursement and accept no responsibility for any error on coding that leads to reimbursement error or investigations by medicare for incorrect coding/billing.

Thank you for your time........

[merlee]

They wouldn't have entire courses to train people in coding if it was easy!!!!

No, not something every nurse should be doing; the wrong code leaves the facility open to not getting paid!

Not a good thing at all.

[Lynx25, LPN]

We have do do these for labs, and all I've got to go by is a 1 page handout. I ended up using the wrong code one day and got hauled into the office- nurse manager fussing her brains out.

I asked her, "Well do YOU know the correct code?"

Turns out she had no idea either. -.-

It's complicated material, don't expect me to do something without giving me any resources.

[ZenLover, MSN, RN, NP]

In a previous life I was a certified coder and certified office manager. I started coding BEFORE you could obtain a certification. The reason why they have classes teaching coding is not because it is really difficult, but because the people doing it most of the time have NO idea about anything medical. They have no anatomy and physiology knowledge and certainly are not trained diagnosticians. Actually Medicare had the bright idea that treating physicians should be responsible for all the patient coding. The idea being that the person who is most familiar with the patient's condition should "code it".

Now, you can get into trouble for coding wrong. In your instance this would be the hospital really. A lot of places are trying to go to this b/c most certified coders coming from a 3 semester community college don't know the difference b/w a hernia and a broken femur, you do. The new computer programs available replace the huge books and are "supposedly" easier to use. But if you have not been trained on the basics, which may take about a day for someone already in the know about where the knee is located...it would be overwhelming. Really coding is nothing more than charting using numerical short cuts. You just need to be familiar with what the numerical short cuts are.

[netglow, ASN, RN]

Well, so it goes.

All those HIT students, and people with an OK career planned. They are going to school and paying out to get their AAS or whatever, but are probably being slowly removed from the workplace now before they start, and don't even know it.

Hmmm. Also HIT folks at the CC near me are required to take BIO and A&P.