Ambulatory medical billing and coding differ quite a bit from other inpatient billing and coding. This is because the health services are provided through hospitals or ambulatory surgical centers (ASC) at an outside location, making the service and outpatient service. For this reason, strict guidelines and regulations have to be made by the government through the Medicare program. Let’s take a look at how and why ambulatory coding is difficult.
Ambulatory coding challenges are threefold:
Coding for ASCs is unique because many of the health services provided do not require a hospital visit. That means that hospitals or physicians have two very different types of coding needs.
Because ambulatory coding is so different, finding extraordinarily educated coders in this specific field can be difficult, but proper coding is imperative. Without a strong ability to code for ambulatory services, reimbursements can decline.
Coders in this specialized field know that one of the biggest issues with ambulatory coding is time. Ambulance services are rendered quickly. This leaves no time for details. In an inpatient setting, coders can talk to the physicians and get specific details on the healthcare provided. This is great information for any coder that isn’t specialized in this field. Without a deep knowledge, time would be the only way to understand exactly what happened, but with ambulatory services, it is definitely lacking.
Where coding for ambulatory services gets even more complicated is in its frequent changes. In most cases, in-house coders have to be well versed in inpatient and outpatient codes. All of these codes are changed quite frequently, but ambulatory codes may be changed the most often.
Every single year the Centers for Medicare and Medicaid Services create a new list for the outpatient surgery procedures accepted. This means that new surgeries will be added, and some taken away. It is very difficult for coders to continue to re-educating themselves when the changes are so in-depth and frequent.
The best solution to the above ambulatory challenges is to outsource your medical coding. By outsourcing, you are guaranteeing a person with in-depth knowledge is running your codes. Additionally, paying for the continued education of coders would no longer be a burden. If you are interested in learning how a professional medical coding company could help you, MEREM Health would love to hear from you.
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