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J. Ho, A. Nathan, G. Abedi, M. Subramanian; Learning to Code - The Discrepancies Between Ophthalmology Residents’ Perceptions, Training and Knowledge of Coding. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3774.
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Sixty percent of newly-qualified ophthalmologists are not prepared for business and management aspects of their clinical practice. Physicians across different specialties have reported that training in coding compliance, reimbursement and practice management is often overlooked during their residency training. This study aims to evaluate ophthalmology residents’ perception of their knowledge and level of training in coding and reimbursement.
Residents from a Boston University ophthalmology residency program were invited to complete a 21-question survey covering education, subspecialty fellowship interests, training in coding and knowledge of coding procedures. Data was gathered using anonymous, self-administered, standardized online questionnaires which were analyzed with spreadsheet software.
Completed surveys received from 10 of 12 residents (83% response rate) revealed that all respondents felt that coding was an important part of residency training, but 90% feel unprepared to code after residency.In terms of knowledge, while 70% correctly described that a sample case scenario should be coded as a consultation, only 40% could define the difference between level 3 and 4 codes. Only 30% could name a penalty for over-coding and only 20% could identify a necessary item of information that is required to code for a consultation. While all residents had received at least one official teaching session on coding compliance, only 40% had received personal instruction on the subject from an attending. Furthermore, no residents currently used the American Academy of Ophthalmology or other websites for assistance and information on coding, with 40% of residents relying solely on a departmental coding reference sheet.
Ophthalmology residents need to improve their knowledge of coding procedures in order to develop their proficiency in a subject area which they unanimously agree is important for future practice. It is also important to correct the lack of awareness of potential financial penalties and legal liabilities that may ensue from improper coding. Improved training in coding should therefore incorporate more direct attending instruction, continued didactic lectures and encourage residents to utilize various online coding resources to expand their understanding of the subject.
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