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What is your coding process?

Posted
RRlc RRlc (New) New

Hello,

I am looking to hear what your agency's process is for coding. The company I work for is looking to improve our process.

Currently our nurses fill out a coding worksheet after their SOC/RECERT/ROC with the patients diagnoses for M1010, M1012, M1016, M1020/1022. They list the severities on this sheet as well and then turn it in to our Coders in the Quality Improvement Dept. Next the coders put the codes into our system. Our trouble is many of our clinicians do not hand this form in, in a timely manner and often the coders have many questions for the clinicians. The coders go into the referral paperwork each time to get more information and verify the codes they put in, make changes and get concent from the nurses. We are working on updating our coding worksheet.

Some more questions:

Does your agency precode?

Are you paperless?

What computer system do you use?

What dept are your coders in?

Are your coders nurses and are they certified?

How do you make corrections when needed?

Thanks in advance for any info!!!