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National Coding Contest Indicates Outpatient Coding Quality Challenges

Posted by David Fong on Feb 13, 2020 5:15:00 PM


A recent article in ICD10 Monitor reported that a national coding contest held annually found outpatient coding in 2019 had the worse coding accuracy in the past three years. Central Learning has held this coding contest since 2016.

The annual contest focused on outpatient coding, because of the industry growth in outpatient services and shifts in payment methodologies. More than 4,000 cases were coded by contestants -- 81% of which were AHIMA and/or AAPC certified and 82% with more than five years of coding experience. It found an accuracy rate of 60.5 percent for primary diagnoses, and only 38.6 percent for secondary diagnoses. The analysis indicated among the coding quality issues were a lack of specificity in the primary diagnosis and failure to follow coding principles and guidelines in secondary diagnoses.


Aviacode delivers medical coding solutions that work to provide a 95% accuracy with over 700 skilled AAPC or AHIMA certified medical coder employees who are hired only after passing proprietary exams and are provided ongoing training. Aviacode's coders are not only experienced with inpatient coding, but also with more than 60 outpatient medical specialties.


In addition, Aviacode offers comprehensive audits of coding-related practices that are aimed at improving coding accuracy, thereby minimizing coding compliance risks and reducing coding-related denials. Coding audits, which are the validation of code assignment against the supporting clinical documentation and coding guidelines, are instrumental in ensuring coding accuracy.


Topics: ICD-10, Medical Coding, Pro-Fee Coding, Outpatient Coding