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Do you think MM could work their coders like they - work their MTs in India?

Posted: Sep 19, 2014

They are usually trained to do only one particular type of report, not everything, and so they are not really trained as MTs.

Can coding for institutions be broken down like that? I had a friend who worked as a coder at a local hospital. All she was given to do was outpatient ERs, and the "real" coders did all the inpatient work.

Being MM, I'm sure they can make your training as "coders" almost worthless.

The main issue I see with MM expanding - further into coding

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is their agenda. Of course they want to make money coding, which means:
1) Getting as many accounts/facilities/clients as possible, which means:
2) Underbidding and/or convincing facilities they don't need their inpatient coding staff, which means:
3) To underbid, they have to offshore and/or pay their US coders less than the going wage, which means:
4) a repeat of their part in pushing "cheap" transcription.

Bingo. It's the only way M*M knows: Infiltrate - a new field, then slash and burn. N/m

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Types of coding - Coder

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In considering that situation, I think you need to keep in mind that one-upmanship occurs just about everywhere. You should also know that there is a long tradition of inpatient coders thinking their work is "real" coding and everything else is not.

There is a considerable difference between inpatient and outpatient coding, but they are both "real" coding. I know outpatient coders who cannot do inpatient and vice versa. Relatively few do both at the same time. Most specialize, and some outpatient coders specialize in one specialty, like ED, orthopedic surgery, or interventional radiology. Some of those specialists make more than inpatient coders.

All coders have to learn to code in general to a certain degree. They have to learn TO CODE. They have to learn the fundamental body of knowledge that is common to all coding. Once they know that, they can do whatever their course focused on or what they prefer. Later, they can fairly easily switch to something else.

Any coder who is familiar with the books they are using will see right away that they are learning coding appropriately and that it will apply to both inpatient and outpatient. There is nothing wrong with the content that I can see.

You can train a chimpanzee - to code ER and outpatient

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Give her a cheat sheet and she can knock out 99% of the charts she gets in short order. Inpatient coding is another matter, complex and fraught with payment consequences. That is where you put your coding knowledge and experience to work.

Yup, one-upmanship is everywhere - Coder

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If you think it is so easy and that there aren't payment consequences to outpatient coding, you are missing something.

Well I'm confused. I work in a small GI office with - 2 docs and they have a

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person who does the coding for only inpatient GI office visit. I believe she was trained in house. I don't think she has any coding training or credentialing, but she is insistent on being called a coder. Is she really a coder?

Difference between the job and the person - doing the job

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There is a big difference between the job itself and how one does the job. We don't want to go away thinking that GI office coding is not coding because of one person.

Can GI office coding be "real" coding? Yes. Can it just be "billing"? Yes.

If you have a large GI office doing a wide scope of procedures, and if you have a coder who actually codes them rather than using a cheatsheet and plopping the same codes on each thing, and if that coder actually levels the E/M services, then it is coding. If that person is responsible for assessing and advising on codes for the charge ticket forms, and if that person reviews and audits the physicians' code choices and corrects them, it is coding.

On the other hand, if you have an office doing less scope, and if the doctors check off the diagnoses and procedures on the charge ticket, and the person just adds them unchanged to the billing form, then it is billing, not coding. If the doctors decide on the codes for the charge ticket, or if an outside consultant or professional association does it for them, then it is billing, not coding.

If a person was trained in the office to do that one job and is not certified, then I would not be likely to think they were a coder. They would not meet the requirements for coding jobs.

There is an overlap between coding and billing, especially in small offices. Some coders code and also bill. At some point, this becomes impractical. With enough volume, coders code and the codes are passed to billing, which prepares the bill.

Whether your person is doing coding or not has nothing to do with whether GI office coding is real coding. It is real coding where I work. Might not be at your office. Your person may or may not be "a coder." Hard to tell from the information you provided.

As for calling it "coding," most people in offices like that are going to call it coding and you can't convince them otherwise because it is all they know.

I'm currently an outpatient coder - please sm

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I am trained in both IP and OP and passed both the CPC and CCS. I can assure you, I am no chimpanzee and I still have a WHOLE lot to learn on both inpatient and outpatient, but, yes, I do consider myself a coder.

Outpatient - Coding

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I agree with you about outpatient coding being real coding as I am also an outpatient coder for a specialty clinic. I really cannot see a chimp being trained in EM leveling.

Agree, we tried to train our inpatient coders - to do it

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Most of them hated it. Thought it was too complicated.

I do both. It is more a preference or style than anything else. It is not that one is more difficult.

outpatient - Coding

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How is outpatient coding something a chimpanzee could do? I code outpatient professional fee level services for a clinic that includes a variety of specialties. I also have to pay attention to dates, modifiers and do a lot of EM leveling. Also I am expected to code from the entire note which includes the patient's chronic conditions and not just the acute problem. A chimp could enter the codes after I find them, but how can a chimp figure out what to code?

really? don't know much, do ya? - cj

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Wow, I thought I had seen some insulting things on here but this one takes the cake! You really don't know much about coding do you? An outpatient coder has very specific skills. As an outpatient coder one has to know both ICD and CPT coding, E&M leveling, Charge capture, etc. Outpatient coders will code clinics, ancillary services, day surgeries, caths, interventional procedures, observations and short stays just to name SOME of what they do. And as for payment consequences, get real. OPs may not have the high dollar charts for one single patient that inpatient does, but our facility averages 1400 to 1600 OP Clinic and ancillary visits per day, about 100 ER visits per day, 150 to 300 day surgeries a day, every single day. What this means is that our outpatient revenues exceed our inpatient revenues.

That is so - one month ago

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zzzzzzzzzzzzz

Yet, you were here reading it ... yet had nothing - constructive to say. nm

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NM

MM's focus is outpatient, currently - CT

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Per all their reason PR, their focus going forward, at least in the short term, will be offering effective and efficient cost containment of outpatient coding services through outsourcing or other sorts of service pairings. No word, as yet, on the inpatient side, though I suspect once that is streamlined in a sense, it too will be on MM's plate.

"Cost containment" is usually the death knell - of a profession. nm

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If they "make your training as 'coders' almost - worthless," as you say...

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... you aren't going to be able to do the work.

Not much point in their cunning plan, then, is there?

I think that's pretty much a given, considering - it is M*M theyre dealing with.

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nm

wow someone is feeling very threatened - to come on here and randomly post about MM

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If you are so sure they are going to fail why do you care? You must have job security concerns. Or maybe you are just jealous MM coding trainees are paid to learn, not the other way around like you probably did.

Agree with sounding threatened -- must not have - been selected

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NM

Not threatened and not chosen because I'm - 2 months from full retirement

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All I have to do for my money from now on is simply stay breathing!!!

The thread started out as an MM post - not random at all nm

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nm

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