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Using faculty development to solve a problem of evaluation and management coding: a case study.

E A Rose1, L M Roth, P T Werner

  • 1Department of Family Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA. erose@med.wayne.edu

Academic Medicine : Journal of the Association of American Medical Colleges
|July 13, 2000
PubMed
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Physicians faced challenges with Health Care Finance Administration (HCFA) billing and coding rules. A faculty development curriculum significantly reduced coding errors, improving compliance.

Area of Science:

  • Medical practice management
  • Healthcare quality improvement
  • Medical education

Background:

  • Physicians, particularly in academic settings, struggle with compliance to Health Care Finance Administration (HCFA) billing and coding regulations.
  • Accurate medical billing and coding are crucial for healthcare reimbursement and regulatory adherence.

Purpose of the Study:

  • To assess the effectiveness of a faculty development curriculum designed to improve physician compliance with HCFA billing and coding rules.
  • To reduce errors in medical coding within an academic family medicine practice.

Main Methods:

  • A comprehensive curriculum was developed and delivered to faculty, covering coding theory, chart auditing, team building, and problem-solving techniques.
  • Pre- and post-intervention chart audits were conducted to compare coding accuracy.

Related Experiment Videos

  • Statistical analysis was used to evaluate the significance of changes in error rates.

    • Main Results:

    • The overall medical coding error rate decreased significantly from 50.2% to 31.1% (p < .05).
    • Overcoding errors reduced by approximately one-third (29.1% to 19.7%), and undercoding errors were halved (16.3% to 8.4%).
    • Other coding errors saw a reduction from 4.7% to 3%.

    Conclusions:

    • A faculty development program incorporating work teams and quality improvement tools can effectively enhance physician compliance with HCFA billing and coding guidelines.
    • Integrating problem-solving into faculty development initiatives is a viable strategy for addressing practice-specific challenges.