Job Description

Assign diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the inpatient, emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and principal procedure, as well as, all other significant diagnoses and procedures. Abstract hospital-defined data from records for data collection purposes. Ensure compliance with official guidelines (ICD-10-CM, ICD-10-PCS, AMA CPT Assistant and Guidelines, and/or AHA Coding Clinic), AHIMA Standards of Ethical Coding and LifePoint Health Support Center (HSC) policies and procedures.

ESSENTIAL FUNCTIONS:

• Assign ICD-10-CM, ICD-10-PCS, CPT and/or HCPCS codes correctly with a coding error rate of less than 5% in accordance with established guidelines for reimbursement and statistical data.
• Maintain quarterly minimum 95% coding accuracy.
• Must be familiar with Diagnosis Related Groups (DRGs), Ambulatory Payment Categories APC’s), the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative guidelines, Local and National Coverage Decisions and other medical necessity/compliance guidelines for billing and coding.
• Follows department workflow for service type to include addressing compliance reviews. Contacts physicians and/or ancillary departments when additional information is needed to accurately code the record.
• Prioritizes coding functions to assure records are coded within facility defined number of days from discharge. Collaborates with the team to maintain and exceed DNFC goals while maintaining good employee relations.
• Meets coding productivity standards on a consistent basis as indicated by HSC standards.
• Submits physician queries when clarification of documentation is needed.
• Refers coding questions to coding auditors, coding managers and/or coding leads. For those cases where the diagnosis is obscure, determines the most appropriate diagnosis after a thorough review of the medical record and queries the physician.
• Decreases pending accounts with timely follow up. Daily review and response to Business Office holds.
• Accurately enters code hold reasons into abstracting system.
• Identifies any patient type admission order discrepancy or discharge status discrepancy and works with case managers and admitting to code the account with the correct status.
• Uses independent discretion/decision making while effectively working alone.
• Attends educational webinars, conference calls, other coding seminars, and participates in all formal and informal coding discussions. Complete all assigned compliance courses within assigned period of time.
• Maintain at least twenty (20) continuing education hours annually and maintain required credentials.
• Conforms to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy and ensures patient/employee privacy and dignity by maintaining confidentiality with no infractions.
• Other related job tasks or responsibilities as assigned.

Additional Information:

Position serves both internal co-workers and external customers, clients, and contractors.

Access to and/or works with sensitive and/or confidential information.