Failed a Medical Coding Audit? Here's what to do next

So you failed your last medical coding audit, now what?

Start with education. Using educational content can be a helpful approach to address any QA issues and improve your coding skills. 

Here are some steps you can take after a failed medical coding audit:

  1. Identify the areas of opportunities: Review the audit results and identify the specific areas where you faced challenges. This could be related to coding guidelines, documentation requirements, or specific code sets.
  2. Access educational resources: Look for targeted educational content that can help you strengthen your knowledge and skills in the identified areas. There are several options available:
    • Online courses via an educational platform: Subscribe to an educational platform that offers online courses focused on medical coding. Look for reputable sources that cover the topics you need to improve.
    • Coding books and manuals: Acquire authoritative coding books and manuals, such as the Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) manuals. These resources provide detailed guidelines and explanations for accurate coding. 
    • Coding forums and communities: Engage your peers on coding forums and communities where coding professionals share their experiences and knowledge. Participate in discussions, ask questions, and learn from others' insights. 
    • Industry publications and newsletters: Subscribe to industry publications and newsletters that provide updates on coding guidelines, regulatory changes, and best practices. These resources can help you stay up to date and improve your coding accuracy. 
  3. Develop a study plan: Create a structured study plan to ensure you cover all the necessary topics. Set specific goals and allocate dedicated time for studying each day or week. Prioritize the areas where you need the most improvement. 
  4. Practice coding scenarios: Hands-on practice is crucial for improving coding skills. Look for coding scenarios or case studies that replicate real-life situations. Practice assigning accurate codes based on the documentation provided and review the answers to learn from any mistakes.
  5. Seek feedback and mentorship: If possible, find a mentor or experienced colleague who can guide you through the learning process. Reach out to the auditor who performed your review and ask for feedback and  suggestions for improvement.
  6. Ask for another audit: Once you feel more confident in your coding abilities, discuss with your supervisor or QA team about scheduling a follow-up audit. Apply the knowledge you've gained through educational content and strive to meet the productivity and quality requirements.

Remember, improving coding skills takes time and consistent effort. Be patient with yourself, stay motivated, and continue seeking opportunities for professional development.

If you’re looking for a reputable online medical coding resource, HIAlearn offers monthly and annual subscriptions, as well as bundled training plans to cover notoriously difficult medical coding topics.

We also recommend signing up for our newsletter. Our weekly digest, called Coding with a Cuppa, will highlight the most current coding education topics that you need to know.

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