Are you aware how coding affects your reimbursement? How well are you coding your services? Use the AAP Coding Calculator to find out.
One way to make sure to get paid for what you do is to make sure that you are coding correctly. To enhance your practice's coding, make sure to utilize appropriate codes to report your services. Undercoding or reporting codes of lesser RVUs reduces practice revenues. Overcoding or reporting codes of higher RVUs without having documentation to support the level of service can lead to a greater incidence of chart audits and take backs by third party payers, and charges of fraud.
Some pediatric practices tend to undercode, especially with Evaluation and Management (E/M) codes. This affects revenue, quality measurement, and incentive based compensation programs that utilize claims data. To see how your practice's E/M coding affects your potential revenue, use the AAP Coding Calculator. This model is presented for general comparative purposes only and does not imply AAP recommendation of a specific distribution of E/M codes. Actual distribution of E/M codes may vary based on the practice's patient population.
The AAP has developed workshops and reference materials for coding resources. Some AAP chapters also may have coding trainers. For assistance with coding questions, contact the AAP Coding Hotline. To report issues and concerns regarding health plans and carriers, complete the online Hassle Factor Form.