actual ASC operative reports repre- senting procedures performed at your facility. I always recommend giving them a timed coding test to ascertain accuracy and potential productivity.” Misty Kelly, administrator at Pre-


mier Surgery Center in Brunswick, Georgia, suggests that the test include easy to complex coding examples that pertain to the specialties performed at the facility. “The candidate should be given the most current coding books to use for reference,” she says. “Quizzing your candidates on their knowledge will help eliminate those who may present themselves well, have great personalities and appear to be a great fit for your facility but fall flat when it comes to coding.”


Training ASCA’s annual coding seminar is a good place to keep abreast of the ever- changing codes, Ellis says. “One-on- one training is also good. It is time- consuming, but you’ve got to make sure that what they are doing is right. Online training might be available, too.” Kelly says, “Now that we are uti- lizing ICD-10 codes, it is more impor- tant than ever to have your coders well- trained. Your facility cannot afford to have a coder who isn’t coding to the fullest extent possible as you do not want money left on the table. Provide coders with all current manuals, access to ASC coding web sites such as ASC Expert, periodicals with updates and changes to codes.” Another great way for coders to


learn and share their knowledge is to reach out to fellow coders within their health care management company and/ or the ASC community, Kelly says.


Retaining “To retain coders, pay them well and appreciate them,” Ellis says. “Give them feedback and tell them what they are doing right and what they need to change. Find out what they are strug-


When to Outsource


An ASC would need to evaluate several criteria prior to outsourcing, says Misty Kelly, administrator at Premier Surgery Center in Brunswick, Georgia. Below are a few key reasons she would consider outsourcing.


• You have been unsuccessful in obtaining a qualified coder.


• Your ASC’s case volumes are exceeding an amount that your coder can realistically keep up with while continuing to perform at a satisfactory level.


• Your ASC is multi-specialty and you are concerned that there are coding deficiencies in one or more areas due to the vast differences in the specialties that you serve.


Compile a short list of questions before reaching out to outsourcing companies, and be sure to ask the following, Kelly suggests:


• How long have you been coding for ASCs?


• What fees do you charge? Are there different fees for different specialties, such as orthopedics versus ophthalmology?


• What is the expected turn-around time once the coding is sent to you? • How often are you audited? • What is your coding audit score?


• If I disagree with your code, what are the steps involved to get a better understanding of the reasoning behind your codes?


Coders should have, at minimum, a working knowledge of coding ASC procedures before you hire them.”


—Cristina Bentin, Coding Compliance Management


gling with and the tools they need to do their job. Give them reviews. It is hard to find good coders, so you really need to work with them.” As with many positions within an ASC, coders tend to cap out at a certain wage and without further incentives to keep them, there is always the risk they will get scooped up by another ASC with a more lucrative offer, Bentin says. “I have seen some ASC facilities offer additional vacation time when a coder is capped at an hourly rate,” she says. “Pay your coder(s) according to their expertise. Consider the geo- graphical region when determining wages since hourly pay is diverse for coders. Provide them with incentives


appropriate for your facility, such as providing continuing education, reim- bursing for annual dues and ensuring that they keep up with your facility’s reporting and directives at your facil- ity’s expense.”


Performing on Par To keep the process efficient, all cod- ers will need to understand that there will be times that they must query a physician for clarification on an oper- ative report, Kelly says. “This will ensure that there are no assumptions being made as to what the physician ‘meant’ versus what is factual.” For internal coders, have quality measures in place for on-time coding


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