Cardiovascular Business - July/August 2008 - (Page 27)

an initial audit of the remote coding service found it could save the practice hundreds of thousands of dollars annually. Brian Rutledge, manager of business and clinical operations, Division of Cardiovascular Diseases, University of Mississippi Medical Center, Jackson hen Brian Rutledge became the manager of business and clinical operations in the Division of Cardiovascular Diseases at the University of Mississippi Medical Center in Jackson in 2006, he found a division that had not changed much in nearly 30 years. The coding, in particular, was problematic as the system and personnel had not kept up with the rapidly changing nature of cardiovascular procedures and coding. Rutledge found coding errors in complex as well as simple cases. He found problems with peripheral vascular and electrophysiology (EP) cases. Some complex procedures can have up to 15 different codes, each potentially reimbursing $1,500. “Missing just a few of these over the course of the year can mean tens of thousands of dollars in lost charges,” Rutledge says. He also encountered communication issues with the billing office, which tended to not give feedback regarding denied claims. “You can’t recover what you don’t know you lost,” he says. When he looked for new personnel, he found it difficult to locate highly qualified coders. He heard about CodeRyte, a computer-assisted coding company based in Bethesda, Md., and decided to give them a chance. He crunched some numbers and found that CodeRyte’s cost would be half that of a full-time coder, including fringe benefits, salary, overtime and “the headaches of managing an employee.” W Now more than ever Rutledge needs to recoup every legally earned dollar. They are in a growth phase, expecting to double the size of their practice by year’s end. Three interventionalists and two electrophysiologists have recently joined the existing practice of 10. He began using CodeRyte in November 2007. An audit of the first 25 patient encounters handled by the new service revealed that the old manual coding system was potentially losing hundreds of thousands of dollars a year. While it’s difficult to compare this year’s numbers with last year’s, given a practice plan consolidation and an increase in the practice’s fee schedule, Rutledge says his codes are more complete, more accurate and charges are up. In March 2008, the department had the largest month of gross charges ever, which could be partially due to the increase in the fee schedule, but Rutledge gives a lot of credit to the automated coding system. Besides the cost savings, he points to an improved turn-around time. They have gone from a four- to five-day lag time, which involved several handoffs to various departments and making copies along the way, to a 24-hour turnaround ending with an electronic submission to the billing office. Periodic audits If a practice is performing its own coding, it’s imperative to conduct periodic audits to determine what if anything is out of the Uneven Coding Ratios Should Raise Red Flags CODE 93543 93555 93545 93556 PROCEDURE GROUP A inJeCt leFt VentriCle S&i leFt VentriCle inJeCt CoronarieS S&i CoronarieS 1759 1205 1948 1333 NUMBER OF CLAIMS GROUP B 4124 3876 4258 4296 GROUP C 828 822 917 876 GROUP D 391 392 392 392 Many procedure codes involve a corresponding supervision and interpretation (S&I) code. If an audit reveals a strong deviation from a 1:1 ratio between the two, practices should investigate the problem. Source: MedAxiom Business Ofﬁce Coding Network CardiovascularBusiness.com Cardiovascular Business 27 http://CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - July/August 2008

Cardiovascular Business - July/August 2008 Table of Contents First Word Cover Story: Planning for the Ideal Cath Lab Requires the Multidisciplinary Approach Clinical Study Digest: Cell Phone Technology Speeds Ecgs As Real-Time 3d Echo Matures, It Finds a Clinical Niche Ecg Image Management Brings Increased Productivity and Confidence Overcoming Barriers to Cath Lab Inventory Control Maximizing Reimbursement, Minimizing Penalties News & Views Calendar Reader Resources The Back Page

Cardiovascular Business - July/August 2008

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