According to Peter Beck, a physician and medical IT consultant, software potentially can make coding tremendously easier, or it can make it more cumbersome.

"Most systems have a coding lookup that enables you, if you know the code number, to enter the code number and it will pop up the actual diagnoses phrase that you can then insert into your chart," he says. "Or you can search by a partial name, such as diabetes, and pull up the diagnostic codes for diabetes. The system, if well-designed, allows you to do a search very easily and it will basically guess ahead."


He also says that some systems' look-up method can be very rigid, so you need to know exactly what you are looking for. But these are becoming less and less common as improvements and new technology are being integrated into the software.

"There are systems now that allow lookup to be very easy, even if you only know part of the code or are close enough," Beck adds. "It will guess ahead and usually nail it. When it's well done, it's one of the most highly prized and praised aspects of EMR."

As for saving money, Beck points out that since a physician is doing the coding himself or herself at the point of contact with the patient, there isn't as much need to pay a coder externally to come in to chart and guess from a doctor's handwritten scrawl.

MD On-Line streamlines the process by using a tracking system, similar to the way FedEx keeps track of your packages. The company double-checks all eligibility requirements and then forwards the claims to the insurance company. A few days later they check on the claim, and track it until the reimbursement is in the doctor's hands.

"The doctor submits the claim to us and they don't need to get on the phone and call the insurance company as we are constantly pushing the information over to them," Bartzak says. "This means less time on the phone for coders and more time to fix the bills that need to be fixed."

This system allows a doctor to get paid anywhere from 3-7 days after filing the claim. When you are doing it on paper, it could take up to 45 days.

Coding Problems

Recently, the Health Department in Philadelphia had a situation where some pediatricians thought that some kids may have had the chicken pox and it was one of the things they needed to find out, so they made notes on their coding charts, which later were mistakenly entered when the kids were found to be negative for the disease.

"They weren't saying they were diagnosed, just needed to be checked, but for even something as simple as this, there is a code, and they were running into problems," says Jason Launders, senior medical physicist for ECRI Institute. "When using a paper-based system, where you can write what you want, it's interpreted by other physicians, secretaries and coders, providing the opportunity for things to be entered incorrectly."

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