Reference no: EM133476718

Coding Audit and Reporting

Scenario: Imagine that you have just been promoted to the position of Coding Manager at National Medical Center and you are responsible for five fulltime and three part-time coders. On a quarterly basis you, the Coding Manager, are required to complete a coding audit including summary reports for each coder.

Complete the following tasks:

Part I

The former Coding Manager completed the recent 4th Quarter audit but she was not able to complete any of the reports prior to her departure. She has left you with the following audit information on a piece of scratch paper:

Coder 1 88.6 %
Coder 2 96 %
Coder 3 98.9%
Coder 4 92 %
Coder 5 89.9 %
Coder 6 94.6 %
Coder 7 81%
Coder 8 91%
Coder 9 83%
Coder 10 80.7%

You do not know the coding accuracy policy and were not given one when promoted. It is now up to you to create a Coding Quality Policy Manual.

Part II

Create an Excel spreadsheet - Enter the 4th Quarter audit summary information that the previous manager left for you into your spreadsheet, along with the information below that you found in previous audit files. You will need to construct a bar chart showing the history for each of the coders.

CODER QUARTER 1 QUARTER 2 QUARTER 3

1 82% 86% 94%
2 96.8% 98% 95.2%
3 92% 97% 96.9%
4 92% 94% 94%
5 87% 91% 89%
6 94.9% 95.2% 94.9%
7 NA NA NA
8 97.2% 94% 96%
9 88% 87% 89%
10 90% 93% 89%

Part III

You have collected information from each of the coder's file and prepared a table to remind you of their employment status.

CODER LENGTH OF EMPLOYMENT NOTES

1 1 year
2 7 years
3 4 years
4 11 years
5 1 year 2ND Probation
6 2 years
7 42 days Address weak areas
8 2 years Sudden drop
9 5 years
10 3 years 1st Probation

Now you must make some decisions based on the data that you have and the Coding Quality Policy Manual you have created.

1. Which coders are concerns and why? List each one that you are concerned with and be specific about the part(s) of the policy in question.

2. Which coder(s) require an education plan?

3. Do any coders need to be placed on probation?

4. Do any coders need to be considered for termination?

5. Are any coders in their probationary period in jeopardy of not meeting the probationary expectations?