Medical Coding Guidelines

In the May 2014 publication of the AAPC Healthcare Business Monthly I read an article that was very interesting. The title of this article is Guidelines? What Guidelines?

This article talked about how medical coders rely on guidelines to assist them in assigning codes. The author, Ken Camilleis, made several interesting points about coding guidelines. The first point the author makes was “My personal experience suggests that the medical community outside of the coding world often lacks knowledge regarding coding guidelines.” The author then gives an example about a physician that was not familiar with the Official ICD-9-CM Guidelines for Coding and reporting. The article said, “He had no idea these official guidelines even existed. He only worked from the body of the book to find codes in the Alphabetic Index and the Tabular List.” This is very alarming because if the guidelines are not followed there will be errors in code assignments.

The next point the author discussed was the importance of understanding the guidelines. In the article, it says, “You know from experience that there’s more to proper coding than simply looking up codes in an index or list.” The more familiar you are with the guidelines the more accurate your code assignments will be.

The last point that the author made was that medical billers and coders are not the only ones in the healthcare industry that need to be familiar with the coding guidelines. The article says “The chapter-specific coding guidelines in section I, subsection C of the Official ICD-9-CM Guidelines for Coding and Reporting, provide a wealth of information to which doctors and health information management specialists should be privy to.” Understanding and applying these guidelines are crucial to coding compliance and reimbursement.

Read the full article on the AAPC website.

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