10 Best Tips for Coder Education Strategy

You’ve got an education budget for 2021 and an entire team of motivated and knowledge-thirsty coders to teach. The challenging part? Choosing the topics. You need to choose wisely. After all, you’re taking coders out of a production environment for hours or even days at a time. Ideally, the information they glean is timely, immediately actionable, and relevant to your organization.


Following are 10 questions to consider when developing an educational strategy:


1. What’s on the Office of Inspector General’s (OIG) radar? The OIG Work Plan is ripe with ideas for training topics because it’s essentially a playbook for areas of compliance vulnerabilities. Here are some recent topics that easily lend themselves to audits:


· Inpatient claims with short lengths of stay that were incorrectly billed as inpatient and should have been billed as outpatient or outpatient with observation · Medicare payments for COVID-19 inpatient discharges

· Medicare telehealth services during the public health emergency

· Payments to acute care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities (i.e., long-term care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, and critical-access hospitals)


Any of these topics could be broken up into a series of educational opportunities and/or coding workshops to identify best practices and ensure revenue integrity.


2. What are your new service lines or areas of growth? New service lines pose compliance challenges because there can be coding nuances to identify and work through. Areas of growth should also be on your radar because coding mistakes can increase compliance risk at an exponential level.


3. What are your high-dollar, high-volume procedures? This is a common focus for coder education because small mistakes can add up over time.

4. What audit patterns do you see? Internal audits provide a goldmine of information for developing a coder education strategy. You’ll also probably find educational topics for physicians and clinical documentation improvement (CDI) specialists as well. It truly takes a village to ensure revenue integrity.


5. What are your most common reasons for denials? For example, is there a pattern of outright denials or requests for additional documentation? Drill down into the root cause to pinpoint educational opportunities.


6. What are the most recent CMS MLN Matters® articles? MLN Matters articles explain national Medicare policy in an easy-to-understand format, focusing on coverage, billing, and payment rules for specific provider types. Be sure to sign up for the MLN Connects newsletter so

you can understand changing regulations and immediately identity educational topics to address with staff.


7. What guidance has your local Medicare Administrative Contractor (MAC) provided recently? Be sure to sign up for your MAC’s mailing list so you’re in the loop and can act on educational opportunities as quickly as possible.


8. What do your staff identify as areas of weakness? Sometimes the best place to find ideas is with staff members themselves. All you need to do is ask. You could ask during staff meetings, using anonymous surveys, or during annual performance reviews. Be open to any and all ideas that staff present.


9. What’s the buzz in the industry? For example, what topics are you reading about in trade publications and association journals? What are the agenda items on industry-related virtual events? What are people chatting about on LinkedIn or other types of professional discussion boards? Ask colleagues in other organizations for ideas.


10. What education have you already provided? Just because you’ve already addressed a particular topic doesn’t mean it’s completely off the table. Regulations change, codes change, and new providers enter the picture all the time. With each new provider comes the potential for documentation challenges. Take a look at last year’s training topics. Did it feel as though you could have devoted multiple sessions to a single topic because it was complex or confusing, or it generated a lot of questions? If so, forge ahead.


In closing

Once you identify relevant training topics, you’ll need to choose a format that makes the most sense (e.g., webinar, in-person training, online courses, etc.). You’ll also need to decide whether you’ll provide overall training needs for the entire department or break it down by individual or small group. A thoughtful approach to coder education can be dividends in the long-run in terms of ensuring compliance and helping coders meet professional goals.

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AHIMA Approved

This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.