Coding and Billing in Surgical Education: A Systems-Based Practice Education Program

Ghaderi, Kimeya F.; Schmidt, Scott; Drolet, Brian C.

doi:10.1016/j.jsurg.2016.08.011

Cited by 23 publications

(45 citation statements)

References 10 publications

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“…Several studies have proposed the need to implement or improve formal education in billing and coding during orthopedic surgery residency training. ( 18 - 20 ) Regardless of the cause, continuing trends toward simplified coding could be detrimental to the database research community, since a single code cannot be analyzed to compare outcomes between techniques. Thus, the ease and time efficiency of simplified coding needs to be balanced by the need for useful coding data for future research purposes, and increased efforts to train physicians in coding should be implemented.…”

Section: Discussionmentioning

confidence: 99%

Trends in surgical treatment of femoral neck fractures in the elderly

Lehtonen

Stibolt

Smith

et al. 2018

Einstein (São Paulo)

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Objective To analyze recent demographic and medical billing trends in treatment of femoral neck fracture of American elderly patients.Methods The American College of Surgeons National Surgical Quality Improvement Program database was analyzed from 2006 to 2015, for patients aged 65 years and older, using the Current Procedural Terminology codes 27130, 27125, 27235, and 27236. Patient demographics, postoperative complications, and frequency of codes were compared and analyzed over time. Our sample had 17,122 elderly patients, in that, 70% were female, mean age of 80.1 years (standard deviation±6.6 years).Results The number of cases increased, but age, gender, body mass index, rates of diabetes and smoking did not change over time. Open reduction internal fixation was the most commonly billed code, with 9,169 patients (53.6%), followed by hemiarthroplasty with 5,861 (34.2%) patients. Combined estimated probability of morbidity was 9.8% (standard deviation±5.2%), and did not change significantly over time. Postoperative complication rates were similar between treatments.Conclusion Demographics and morbidity rates in femoral neck fractures of elderly patients did not change significantly from 2006 to 2015. Open reduction internal fixation was the most common treatment followed by hemiarthroplasty.

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Section: Discussionmentioning

confidence: 99%

Trends in surgical treatment of femoral neck fractures in the elderly

Lehtonen

Stibolt

Smith

et al. 2018

Einstein (São Paulo)

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“…Along with patient care information, physicians are also responsible for documentation and accurate coding of clinical encounters. 1 The Accreditation Council for Graduate Medical Education has stated that a larger context is part of the responsibility of the physician, and billing and coding are necessary knowledge in postresidency and fellowship training. Due to the challenges of patient volume, medical complexity, and an immense focus on optimizing hospital efficiency, learners often overlook accurate clinical documentation that captures the complexity of the medical encounter.…”

Section: Introductionmentioning

confidence: 99%

“…3 One report suggested that 82% of residents do not receive adequate training for billing and coding. 1 Careful clinical documentation is essential not only for billing but also for communication, education, data collection, quality management, and research. 3,4…”

Section: Introductionmentioning

confidence: 99%

An Interactive Multimodality Curriculum Teaching Medicine Residents About Oncologic Documentation and Billing

et al. 2018

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IntroductionPhysicians recognize the importance of clinical documentation for accuracy of coding and billing, but it is emphasized little in residency curricula, with an even smaller emphasis on oncology-specific documentation. We developed an educational curriculum to teach residents about clinical documentation for cancer patients. Our tool kit includes didactics, simulated history and physical (H&P) documentation, and personal feedback.MethodsA preintervention survey was first administered to gauge baseline knowledge. A simulated H&P was developed that required participants to complete their own assessment and plan. We delivered a 25-minute lecture regarding billing and coding along with documentation tips and tricks specific to hematology/oncology. Thereafter, we handed out a second H&P, and participants had to once again complete their own assessment and plan. These H&Ps were graded by three reviewers using a rubric. We then gave residents personalized feedback using the above data and administered a postintervention survey.ResultsThe postintervention survey revealed that 100% of the residents surveyed found this activity helpful, 83% noted that further knowledge of diagnosis codes was helpful to their learning, 100% noted that that this activity taught them to improve documentation, 91% said they were more likely to use cancer-specific diagnoses, and 91% said they would benefit from direct feedback-based education.DiscussionDidactic and formal education is more effective when combined with hands-on examples and direct personalized feedback.

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“…11,13,14 A variety of teaching methods for practice management have been studied, ranging from lecture series to educational weekend retreats, with varying degrees of success. 8,[14][15][16][17][18][19][20][21] The purpose of this study was (a) to determine the current level of knowledge of surgical resident physicians on topics relating to billing and physician remuneration, (b) to compare the accuracy of residents' billing with the accuracy of the billing of staff physicians already in independent practice and (c) to explore resident and staff physician experiences and opinions regarding practice management education during residency training.…”

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confidence: 99%

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

Austin

Schroeder

2019

cjs

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Background: Practice management is an overlooked and undertaught subject in medical education. Many physicians feel that their exposure to billing education during residency training was inadequate. The purpose of this study was to compare resident and staff physicians in terms of their billing knowledge and exposure to billing education during residency training. Methods: Senior residents and staff physicians completed a scenario-based clinical billing assessment. Posttest surveys were completed to determine exposure to practice management and billing education during training. Results: A total of 16 resident physicians and 17 staff physicians completed the billing assessment. Overall, the billing accuracy of respondents was poor. Staff physicians had a greater percentage of correct billing codes (55.3% v. 37.5%, p < 0.001) and underbilled codes (6.2% v. 3.4%, p = 0.009), with fewer missed billing codes (38.5% v. 59.1%, p < 0.001), compared with resident physicians. The percentage value of correct billings was significantly higher for staff physicians (71.5% v. 56.8%, p = 0.01). In the posttest survey, 100.0% of residents and 79.0% of staff physicians desired more billing education during training. Conclusion: In general, staff physicians billed more accurately than resident physicians, but even experienced staff physicians missed a substantial amount of potential revenue because of billing errors and omissions. The majority of the residents and staff physicians who participated in our study felt that current billing education is both insufficient and ineffective. Incorporating practice management and billing education into residency training is critical to ensure that the next generation of medical trainees possess the financial competence to required to manage a successful medical practice. Contexte : La gestion médicale est un sujet souvent oublié et trop peu enseigné durant les études de médecine. Beaucoup de médecins ont l'impression que la formation sur la facturation offerte durant leur résidence était insuffisante. L'objectif de cette étude était de comparer les connaissances sur la facturation et l'exposition, durant la résidence, à la formation sur ce sujet des résidents et des médecins membres du personnel. Méthodes : Les résidents seniors et les médecins membres du personnel ont effectué une évaluation de facturation clinique à partir de mises en situation. Ils ont répondu à un sondage après le test pour déterminer leur exposition à la formation sur la gestion médicale et la facturation durant leurs études. Résultats : Au total, 16 médecins résidents et 17 médecins membres du personnel ont fait l'évaluation de facturation. Dans l'ensemble, l'exactitude de leur facturation était faible. Les médecins membres du personnel avaient un pourcentage plus élevé de codes de facturation corrects (55,3 % contre 37,5 %, p < 0,001) et de codes de facturation insuffisants (6,2 % contre 3,4 %, p = 0,009), et avaient moins de codes manquants (38,5 % contre 59,1 %, p < 0,001), comparativement aux médecins résidents. L...

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Coding and Billing in Surgical Education: A Systems-Based Practice Education Program

Cited by 23 publications

References 10 publications

Trends in surgical treatment of femoral neck fractures in the elderly

Trends in surgical treatment of femoral neck fractures in the elderly

An Interactive Multimodality Curriculum Teaching Medicine Residents About Oncologic Documentation and Billing

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

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