Medical Billing and coding- Practices

Medical Billing and coding: Several databases, including PubMed, the Paediatrics magazine published¬† Academy of Paediatrics (AAP), and the research database (MU Summons) of the Marshall University Health Science Library were used to search the literature for publications evaluating healthcare coding and billing. The most recent database access was on August 23, 2020. Additionally, the CDC, CMS, and CMS website (CMS.org) were consulted. Websites haven’t been visited since August 29, 2020. In order to find the most recent literature, the initial scope of the search was limited to published works with specified dates between August 2015 and August 2020. The search was then broadened to include more literary publications by include works published after January 2000.

Search technique

Each database was searched using the following keywords: “medical coding AND billing,” “billing reimbursement,” “medical billing AND resident,” and “billing AND coding AND outpatient.” “Health care utilisation statistics within the United States” were looked up on the CDC website. The Mendeley software was used to enter the resources and check them for duplication. Duplicates were all eliminated. Titles were evaluated for topical appropriateness.

eligibility requirements

Studies were chosen based on the following inclusion criteria: attention to strategies for improving outpatient billing and coding; evaluation of the accuracy of coding and billing in outpatient clinics; evaluation of physician or resident knowledge of coding and billing; inclusion of resident educational curriculum on coding and billing; and evaluation of the legality and/or implications of co Studies were disqualified if they met any of the following criteria: they were conducted in a setting other than an outpatient clinical setting, they involved procedure or procedural coding and billing, they had no access to the full text of the publication, or their findings were inconclusive. We only looked at full-text articles that could be downloaded.

Literature choice

The literature was thoroughly searched for information. The PRISMA flowchart in Figure  shows the sequential steps taken to determine the final number of papers chosen for this review. A total of forty-one papers were sought for evaluation after the publications were screened for the specific inclusion criteria, of which five were unavailable. 36 full-text articles were made available for evaluation. 18 of these were judged to provide information that was pertinent and useful to the suggested quality improvement effort.

data gathering procedure
An independent researcher performed data search, assessment, and selection before gathering the data. To analyse and track data, Mendeley software was used.

Analyses of statistics
Since this is a systematic review, no statistical testing was done.

Results

Numerous recurring problems that have an impact on medical practice‘s coding and billing accuracy were discovered when doing literature research. First off, there are no formal coding and billing courses offered during the years of residency, fellowship, and post-training. Second, the electronic health record (EHR) must be properly and thoroughly documented. Additionally, there is a need for medical practise improvement through the application of methods and legal compliance. It gives a summary of each study’s background, objectives, methodology, and findings.

a dearth of feedback, instruction, and education

According to the literature, a significant percentage of physician coding mistakes can be ascribed to insufficient training throughout residency and fellowship training. Survey analysis was utilized in several studies to evaluate physician and resident opinions on the suitability of training in billing and coding. According to these research, both residents and attendings thought their education was insufficient and that they needed more coding and billing training. In a research by Arora et al., 263 AAP trainees participated in a survey and said they were actively involved in billing and coding, yet 75% said they did not feel comfortable with the procedure.