Hi all -
I’ve been asked to contribute some thoughts on Inpatient
coding. While the number of policy
changes and guideline re-writes over the last thirty years rivals that of
“burgers served”, there has always been one constant……QUALITY. With a nod to that constant I’d like to focus
on the single area I feel has had the most significant impact on the Inpatient
coding professional….knowledge.
Let’s take a ‘memory lane’ look at the Inpatient coder. In the early days coders functioned more in
the role of a translator. We were
skilled in medical terminology and had a basic understanding of that ‘thigh
bone connected to the knee bone’ thing.
Using those skills, the information in the patient record, diagnoses and
procedures, were quite literally ‘translated’ into corresponding ICD-8-CM and
later ICD-9-CM codes. The physician’s
word was final and the thought of asking for clarification; well let’s just say
those encounters were few and far between.
Things went alone in this manner for a number of years. Everyone got paid and life was good. Then someone invited our Uncle Sam to the
party. Hang on to your hats folks, we’re
about to find out what’s behind the green door!
Fast forward, it’s nineteen eighty-two, can you say DRG? Knew you could. I believe this single government issued
health care payment policy change caused the transformation of what was a coder
then, into the HIM coding professional we know today. This one single change moved the focus and
thus the skill set and knowledge base of the Inpatient coder from objective to
subjective.
Subjective! Lucy……you
got some splaining to do. Let’s think
about that word…..subjective. “A topic
or issue described or depicted in an artistic work…..to cause to undergo some
experience or action…..to make liable; expose.”
A pretty powerful word indeed!
The focus, skill set and knowledge base of today’s trained,
quality oriented Inpatient coding professional often equals that of a nurse
practitioner. We interpret lab data,
read EKG’s, screen and evaluate physician documentation and clinical
indicators. We understand drugs and
dosage therapies. We are fluent in
medical terminology and can interrupt and process signs and symptoms. We have a solid command of the anatomy and
physiology of the human body. We
converse with various medical staff members, provide education and
clarification to quality control committees.
We review and write appeals for various audits and payment rejections,
and provide support to facility contract services and informatics.
Inpatient coding professions are in high demand today, and the
wider and deeper your fund of knowledge the higher the
quality of your coding. AHIMA will set a
bar for you. Medicare will set a bar for
you and your employer will set a bar for you as well. These should all pale in comparison to the
bar YOU set for yourself my friends!!
Never stop learning and never lose sight of the prize.
Knowledge equals quality and quality assures a successful and
rewarding career you’ll look back on with a smile on your face and joy in your
heart. For me the last 27 years have
been a fabulous, exciting, hair pulling - crazy making experience and I
wouldn’t have missed it for the world!
Debra -
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