TMA Case Study: Coding and Documentation
By David Doolittle


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Time for another pop quiz: What’s the best way to avoid delayed or incorrect payment? 

If you said correct coding, give yourself a hand because that’s exactly right.

Tracking your practice’s coding patterns can both reduce the risk of an audit due to over-coding and help prevent lost revenue due to downcoding. 

On average, practices lose 10 percent to 30 percent of potential revenue because of incorrect coding. 

TMA’s certified professional coders and auditors can help protect your revenue by performing an in-depth review of how your practice documents medical records and codes claims. The review helps streamline coding and documentation processes, and decrease the risk of external audits. 

For example, TMA recently helped a solo pulmonologist in a small, rural community who had received very little formal instruction on how to document medical records, or on procedure and diagnosis coding.

TMA consultants’ findings indicated the physician’s error rate was 70 percent, meaning documentation did not support the level of service reported 70 percent of the time. 

After studying the consultant’s report and receiving hands-on training, the physician’s error rate plummeted to 20 percent. The TMA consultant also identified missed opportunities to capture nearly $95,000 in revenue for the practice.

If you need coding help, contact TMA’s practice coding experts at practice.consulting[at]texmed[dot]org, or (800) 523-8776. You can also visit the TMA website for additional coding resources and information.

Additionally, up to 20 AMA PRA Category 1 Credits™ per physician can be earned when a coding and documentation review is performed for your practice. 


Last Updated On

October 05, 2018

David Doolittle

Editor

(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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