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A. Nathan, G. Abedi, M. L. Subramanian; Ophthalmology Training in Coding and Reimbursement. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3246.
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Residents across different specialties have reported that training in coding compliance, reimbursement and practice management is under-emphasized and sometimes completely overlooked during their training. Our aim was to assess ophthalmology residents' knowledge base and training in these topics.
Ophthalmology residents across the US were invited to complete a 22-question online survey. The web address of the survey was emailed to residency programs across the U.S. Data was gathered using anonymous, self-administered, standardized online questionnaires, which were subsequently analyzed with spreadsheet software.
Fifty five residents completed the online survey. Majority of responders (88%) were from programs along the east coast, with 15 programs represented in total. Approximately 30% from each postgraduate level responded to the survey. Sixty five percent of responders have received at least one lecture on coding during residency versus 35% who had no instruction. Of those respondents who received at least one lecture, none had more than 6 hours of lectures dedicated to the business aspect of Ophthalmology. Over 80% of the residents were not aware of information available on the American Academy of Ophthalmology website, and 92% of residents did not utilize the Academy website for information on new guidelines for coding. Ninety one percent of respondents expressed unpreparedness or discomfort with billing by the end of their residency. Conversely, the majority of residents (96%) expressed the importance of incorporating additional training in coding and reimbursement during residency. The majority of residents were able to correctly define an ICD-9 code and National Provider Identifier, however, as the questions became more challenging, the number of correct responses decreased. Only 22% of residents could identify the criteria necessary to properly code for a consult and 22% could recognize the definition of a level 4 visit.
All US Ophthalmology training programs are accredited by the ACGME. However, according to the data obtained from our survey, adequate training in coding, reimbursement, and practice management appears to be lacking. This may be due to a combination of factors, such as a lack of emphasis by the ACGME or lack of appropriate resources for residency programs to provide training. As a result, the majority of residents who responded to this survey feel unprepared in coding and reimbursement. Improved training in coding should therefore be incorporated in residency training programs.
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