Why You’re Failing Your Internal Coding Audits

You have been working hard, studying, and exploring all the different facets of medical coding. You got your certification. You landed a job. You’ve been delving deep into your medical records and assigning the codes to the best of your ability. You’re excited and proud and feeling confident. But then it happened. 

You failed your coding audit.

It’s often devastating but can happen even to seasoned medical coders. So what do you do when you’ve failed your internal coding audit as a coder?  Here are some suggestions to help work through the findings.

1.  Take a look at each of the cases where there were mismatches and review the documentation for yourself. See if you agree with the feedback or if you have a difference of opinion. It could be that the auditor did not have the depth of knowledge of the specialty that you have and may have missed some deeper interpretations or regulations regarding how that service is supposed to be coded.  Even auditors aren’t perfect and you may have more information to clarify your thought process.  If you feel the audit is incorrect, don’t be afraid to challenge it.

2.  Talk to your employer about additional education. If they feel that there is further training needed, ask them what resources they have available. Is there another coder that can mentor you? Do they have training modules that you can take? Is there a webinar are or seminar that you can participate in that might elevate your understanding?

If you’re informed there is no budget for additional training, there may need to be a very frank discussion about how you’re expected to improve without any additional resources.

3.  Leave your ego at the door. As medical coders, we always want to do things correctly. We pride ourselves in being extremely precise and accurate in our methodology. It comes as a big blow to our egos when we’re faced with the fact that we may not have done something correctly. It happens to the best and even the most experienced coders. Take the opportunity to learn from your mistakes look to improving in the future and growing.

4. Reach out to your network for help. Maybe there’s someone at your local chapter that codes the same specialty and can give you some advice. Or maybe you just need another colleague that understands your situation and can lend an ear for you to vent. It’s important not to let your pent up frustrations affect your work ethic,  attitude, or performance.  It’s OK to be frustrated for a short period, but grant yourself the peace of mind to learn and move forward.

Obsessing over the negative aspects of an audit only serves to feed negativity and promote toxic work culture. Learn from these situations and you’re sure to rise to the top!

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