Proper coding is directly related to physician compensation/reimbursement. Efficiency is defined as being the most productive during a given time frame (the workday) with the least expenditure of energy and with the least waste and/or fewest mistakes. My experience through my medical practice has made it clear that orthopedic surgeons do not like to waste time or spend their time wasted non-productively. They want to spend their time evaluating and treating their patients and not sitting around and doing busy work to fulfill the red tape requirements and other demands put on them by outside agencies, such as the government or insurance companies. Such busy work includes actual filling out papers and/or sitting and working on computers. In general, they do not think that this administrative work is productive time. Over the last several years, the amount of time spent on red tape and busy work has progressively increased and has significantly encroached on the physician’s time. Also, with the advent of the EMR, much more of their time is spent fulfilling the demands of documentation and what is required to complete and close their patients’ records for their day.

Contrary to popular belief, this is not a timesaving way of getting things done. There are considerable niceties that the EMR offers to the healthcare industry and physicians, but timesaving is not necessarily one of them. As it regards diagnosis and procedural coding, the last thing an orthopedic surgeon wants to do is sit down and spend more time doing so (particularly for those events that occur outside of the office setting) either from a large thick book or from a relatively small computer screen. In addition to what the physician does, his office and nursing staff also have to know how to do a certain amount of coding in the course of their jobs to get approval for various tests and studies and for scheduling surgical procedures. Since diagnosis codes and procedure codes are required for this process, they have to be able to be as efficient with their time as possible.

The “final common pathway” is the coder, who has to make sure that the codes are correct and accurate so as to enter them into the claim form properly. They also want to be efficient. Getting it right at the beginning of this process will hopefully get the claim processed by the payor in a timely and shorter timeframe, and again, hopefully with fewer denials, resulting in reimbursement sooner rather than later.

At this particular time, with the entire healthcare system having to use the ICD-10 coding system, I am not able to state or define how much more efficient my book will make physicians, nursing and office staff, and coders, but I strongly believe that it will.

I recently attended an all-day training course specific to orthopedics, presented by an AAPC professional coding instructor. The course, in addition to the didactic instruction, included orthopedic case scenarios for coding practice. I watched other physicians and coders struggle with their large ICD-10 coding manuals when trying to code these scenarios. In general, these scenarios were not particularly complex or difficult. At the time of the course, I did not try to code them. However, when I had the time and peace to do so, and using my book, I coded the 48 scenarios in approximately four hours. Although not necessarily requested by the program, if there was sufficient information in the scenario to do so, I also did the External Cause Codes.

I recently presented a complimentary copy of my book to the orthopedic coder that I worked with when still practicing. When I asked her how she was getting along with ICD-10, she showed and expressed what I would call significant frustration and despair in trying to do her orthopedic coding using either her computer with its coding program or by using her most current edition of an ICD-10 coding manual. She is an experienced coder for orthopedics, and we worked together for about 15 years. I am quite certain that she has been provided appropriate education and training for ICD-10. In spite of that, she was still quite frustrated. After giving my book to her and spending a few minutes explaining how my book worked and was written/organized to her, she immediately appeared to see that it might be very helpful to her and make her coding work easier. When I was ready to leave, she gave me a hug and told me in essence that she would not let the book out of her sight. I talked to this coder two weeks after giving her my book for a follow-up conversation. She codes for orthopedic surgery, plastic surgery/hand surgery, and anesthesia. She did take the time to review My Book carefully, so she figured out how it worked differently from Their Book. She told me she now uses My Book exclusively for coding for orthopedic and hand surgeries. She finds it easier and quicker for these areas than Their Book or the computer program available to her.

At this point, this is all I can produce in the way of "testimonials" for my book for making coding complete and accurate, easier and less stressful, and with improved efficiency and productivity.

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