Coding, Classification & Reimbursement

HIM Coding Pre-bill review

  • 1.  HIM Coding Pre-bill review

    Posted 04-12-2019 08:26
    ​Would be very interested to know what/how other hospital HIM Coding departments identify and manage pre-bill audits internally.   Example, do you do any review of Medicare before billing, etc.?

    Thank you

    DiAnn Martin
    Asst. Dir. Him - Coding

  • 2.  RE: HIM Coding Pre-bill review

    Posted 04-15-2019 11:04
    ​Hi there, if there was a case coded as unspecified sepsis and was not seen by our Clinical Documentation Improvement team, we flag it for review.  All our flagged in our system and then we manually check to see if CDI was on the case.

    Jamey McGowen
    Him Coding Manager

  • 3.  RE: HIM Coding Pre-bill review

    Posted 04-16-2019 11:52

    We use Epic and prebill edits are built into the software.  If you are talking about reviewing coding quality of Medicare accounts prebill, no we do not do that.


    Terry Clark, RHIA, CCS

    Director, Corporate Coding

    Baylor, Scott & White

    (ph) 817-637-6544


    I commit to leading the HIM corporate coding team so that we will provide consistent and accurate coding and billing information.



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