Coding & Documentation Improvement Plan

When physicians document and code patient encounters efficiently, the quality of patient care is greatly improved.  In the past, quality measures have typically focused on the clinical aspects of a practice.  But now quality measurements have expanded beyond the clinical to include business practices as well.  

TMA Practice Consulting is offering up to 20 AMA PRA Category 1 Credit™, per physician, when a Coding and Documentation Review is performed for their practice.  TMA consultants can assist practices in making quality improvements by conducting a comprehensive diagnostic review of physicians’ coding techniques.  The goal is to identify deficiencies and make recommendations to improve overall coding and documentation efficiencies. The CME is awarded based on specific criteria as outlined below. 

CME Criteria 

  

Stage 1

A TMA consultant(s) will conduct an initial coding and documentation review and analyze current coding techniques to include appropriate application of coding guidelines, medical necessity, correct billing practices, reimbursement levels, and code utilization.  5 AMA PRA Category 1 Credits TM awarded for Stage 1

  

Stage 2

The physician(s) will confer with the TMA consultant(s) to determine the future plan of action to address deficiencies identified in Stage 1.  A comprehensive report is sent to the practice outlining specific opportunities for improvement with an agreed upon implementation timeline.  5 AMA PRA Category 1 Credits TM awarded for Stage 1

  

Stage 3 

Based on the findings and opportunities for improvement identified in Stage 2, the physician(s) will undergo a second review of 5 records and report the results of their action plan.  The provided evaluation and reporting forms should be sent to TMA Practice Consulting.  5 AMA PRA Category 1 Credits TM awarded for Stage 1

  

Stage 4

5 AMA PRA Category 1 Credits TM additionally will be awarded for completion of Stages 1-3.      

Last Updated On

June 01, 2016

Originally Published On

May 03, 2011