In addition to coding medical records, supports the coding team and director by coordinating activities that directly impact the coding team. Examples include but are not limited to:
· Ensures that policies and procedures as well as coding guidelines are kept current.
· Communicates coding updates and other information as appropriate.
· Coordinates meetings, education and reference materials such as books orders
· Generates and works reports to support such efforts as Discharged Not Final Billed - DNFB and denial management.
· Works with the Information Technology Dept. and vendors to resolve issues that impact coding.
In accordance with Adirondack Health (AH) approved, CMS, and AMA coding guidelines which includes: inpatient, ambulatory surgery, referred outpatient services, professional services for employed or contracted providers at any of the AH campus locations, Coordinates activities of all coding functions across the Adirondack Health enterprise in a timely manner.
Medical records are reviewed and accurately coded with the appropriate ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS, Evaluation and Management codes. All inpatient medical records are classified to the correct MDC/DRG based on the payment methodology for that specific financial class (MS, AP, APR DRGs). Ambulatory Surgery patient records are run through the APC finder for edits and grouped into either the APC or APG.
Correct Coding Initiative (CCI) edits and Medical Necessity edits are generated on all coded cases and the coders “work” these edits to help with clean claims submission.