WVU Physicians of Charleston Coders Pass Coding Audits With Flying Colors

As part of the Internal Corporate Compliance Plan/Policy, each coder at the WVU Physicians of Charleston practice plan is subject to a yearly coding review for accuracy.   The corporation is please to announce that all WVUPC coders passed the audit with a 90% percentile or higher, an a great achievement considering the stringent guidelines for the audit process.

Twenty-five charges are randomly selected for review for CPT and diagnosis code accuracy by Laura A Sullivan, MSW, CEMC, CPC, the corporate compliance auditor and clinical documentation improvement specialist for the WVU Physicians of Charleston.  Sullivan audits 20 of those charge lines. Those are audited for E&M coding level, procedural and surgical code selection accuracy. ICD 10/diagnosis coding is reviewed for correct sequencing, and documentation vs code selected. “The internal audits are to ensure that if/when we are audited by insurance/federal payors we are correctly billing for services provided,” Sullivan said.

Sullivan meet monthly with Susan B. Saxe, R.N., J.D., director of corporate compliance and regulatory affairs for the WVU Physicians of Charleston to keep coders abreast of the ever growing number of coding changes, as well as providing education on those issues.

“There are so many rules for how to code documentation, from how often you can bill a charge, what charges can and can’t be coded, date, appropriate documentation and payor specific guidelines,” Sullivan said.  “These rules and regulations are usually federal but could be at the payor level. This is a big responsibility.  Having all of the coders pass is a huge accomplishment, especially since we have 2 new coders.”