Ambulatory care involves a myriad of medical treatments and unique considerations. Outpatient care may be provided through many avenues including, but not limited to, diagnosis, injury, treatment, rehabilitation services, acute medical care, and surgical processes.
Ambulatory surgical centers (ASC) are dedicated outpatient surgical settings, and as such, are reimbursed according to specific regulations and industry standards that fall under Medicare, Medicaid, and contractual financial agreements with private health insurers. The Medicare program and its’ regulatory rules set the standard for all other payers.
Medical coders for ambulatory centers need to have specialized training and expertise in the field of ambulatory services in order to fully comprehend the extensive surgical and procedural operations that define this particular medical specialty. A medical coder for ambulatory outpatient services must have an extensive background in medical terminology as well as anatomy and physiology to fully comprehend operative notes and documentation, have the necessary familiarity with ancillary procedure codes, biological concepts, and a thorough knowledge of pharmacological interventions.
According to the AMA (American Medical Association), the ICD-10CM (clinical modification for diagnosis coding) and the ICD-10PCS (procedural coding system) contains 68,000 available codes. The time and attention that a medical practice would have to place on updating and re-training office personnel and coders is better spent in training for the demands of new documentation guidelines and changes in methodology that will be needed in order to provide timely and specific information that will allow medical coders to better evaluate all of the necessary information.
PDN’s staff of professional medical coders, fluent in ICD-10CM coding, will simplify the transition to ICD-10 and will positively impact the physician’s financial basis. Outsourcing ambulatory medical coding needs allows the physician, as well as the front and back office staff, to better focus their time and attention to immediate and critical patient care needs and other required duties.