providing expert coding advice in helpline

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011

Република СрбијаМИНИСТАРСТВО ЗДРАВЉА

Linda Best

14.00 - 14.45 Thursday, 8th December 2011

Providing expert coding advice in helpline



Coding query mechanism

• Two-way process

– Avenue to resolve coding problems

– Provide feedback on problem areas



What is a coding query?

• Answer to problem areas in coding:– New condition – no code– New procedure – no code– Limited medical science knowledge– Incomplete understanding of classification

system– ‘Alone’ coder



Coding advice

• Crucial to the coding process

• Helps maintain accurate and consistent data

• Reduces variations in decisions

• Provides support to coders



Who provides the answers?

• Sound knowledge of:– Medical science– Medical terminology– Coding and classification system– Coding conventions– Coding standards/guidelines



Query process

• Written NOT verbal

– Allows for consistent responses– Storage of responses– No misunderstanding– No misinterpretations– Does not allow for dissemination



Query process (cont)

• Set guidelines

• Document the process– Submission of query– Response to query



Steps in query process

1. Coder responsibility

– Review the classification– Reference texts, web– Seek advice locally– Send off for advice



Steps in query process (cont)

2. Submission of the query– Email– Fax– Web submission

3.Query form– Detailed information

• Enquirer• Query



Example



Example - Electronic




4. Reviewing the query

– Review the classification– Check the query database– Check other classifications– Reference texts, websites– Seek clinician advice




4. Reviewing the query (cont)

– Seek international advice– Circulate & discuss– Prepare a response– Publish the query– Submit feedback to the authors



Query database

• Storage

• Easy reference



Example



Publishing Q&As

• Up-dates coder workforce

• Consistent solutions to problems

• Coder education



Publishing Q&As

• Methods

– Coding magazines

– Websites



Example - Ireland



Example - Australia

The 10-AM Commandments



Example - Australia

providing expert coding advice in helpline

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