Download - Providing expert coding advice in helpline
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Linda Best
14.00 - 14.45 Thursday, 8th December 2011
Providing expert coding advice in helpline
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Coding query mechanism
• Two-way process
– Avenue to resolve coding problems
– Provide feedback on problem areas
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
What is a coding query?
• Answer to problem areas in coding:– New condition – no code– New procedure – no code– Limited medical science knowledge– Incomplete understanding of classification
system– ‘Alone’ coder
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Coding advice
• Crucial to the coding process
• Helps maintain accurate and consistent data
• Reduces variations in decisions
• Provides support to coders
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Who provides the answers?
• Sound knowledge of:– Medical science– Medical terminology– Coding and classification system– Coding conventions– Coding standards/guidelines
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Query process
• Written NOT verbal
– Allows for consistent responses– Storage of responses– No misunderstanding– No misinterpretations– Does not allow for dissemination
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Query process (cont)
• Set guidelines
• Document the process– Submission of query– Response to query
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Steps in query process
1. Coder responsibility
– Review the classification– Reference texts, web– Seek advice locally– Send off for advice
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Steps in query process (cont)
2. Submission of the query– Email– Fax– Web submission
3.Query form– Detailed information
• Enquirer• Query
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example - Electronic
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Steps in query process (cont)
4. Reviewing the query
– Review the classification– Check the query database– Check other classifications– Reference texts, websites– Seek clinician advice
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Steps in query process (cont)
4. Reviewing the query (cont)
– Seek international advice– Circulate & discuss– Prepare a response– Publish the query– Submit feedback to the authors
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Query database
• Storage
• Easy reference
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Publishing Q&As
• Up-dates coder workforce
• Consistent solutions to problems
• Coder education
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Publishing Q&As
• Methods
– Coding magazines
– Websites
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example - Ireland
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example - Australia
The 10-AM Commandments
Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011
Република СрбијаМИНИСТАРСТВО ЗДРАВЉА
Example - Australia