The Coder’s Guide to Physician Queries, Second Edition

Dr. Jillian Harrington, MHA, CPC, CPC-I, CPC-P, CCS, CCS-P, CEMC, MHP

With frequent ICD-10-CM/PCS code updates, policy changes, and advances in electronic query systems, coders are constantly being challenged to redefine where and how they generate queries. Without an efficient and effective query process, facilities risk denials and audits that can cost them significant time and money.

What’s new in this edition? The Coder’s Guide to Physician Queries, Second Edition, includes new and revised AHIMA/ACDIS query guidelines, updated regulatory guidance for fiscal year 2021, and even more outpatient physician query information!

The Coder’s Guide to Physician Queries, Second Edition provides easy-to-follow strategies for coding departments to improve their query processes and train their coders on developing and executing physician queries. Using the tools in this guide, new and established coders can revise their practices and train staff to meet the challenges of integrating ICD-10-CM/PCS codes into queries, government payer initiatives, auditor denials, and electronic advances.

With sample queries, policies, and procedures for both inpatient and outpatient perspectives, The Coder’s Guide to Physician Queries, Second Edition is a valuable addition to any coding library.

In addition to sample queries and templates, this book provides:

• A comprehensive review of queries, including best practices for coders in an evolving regulatory environment
• An overview of healthcare reimbursement initiatives pertinent to coder query practices in the current regulatory environment
• A start-to-finish guide on the entire query process, including:
• How to develop a facility/systemwide policy and procedure
• How to review the record
• How to understand physician judgment and leading queries
• An overview of query types
• Analysis of AHIMA guidelines for physician queries and compliance concerns essential for coding integrity and success

Published: May 2021

Page count: 110
Dimensions: 8.5” X 11”
ISBN: 978-1-64535-104-7

Table of Contents

• Chapter 1: Healthcare Reimbursement Advancements
• Chapter 2: Assessing the Regulatory Environment
• Chapter 3: Reviewing the Coding Evolution
• Chapter 4: Examining Query Guidance
• Chapter 5: Redefining Query Types
• Chapter 6: The Electronic Health Record
• Chapter 7: Query and Documentation Improvement Outcomes

About the Author

Dr. Jillian Harrington, MHA, CPC, CPC-I, CPC-P, CCS, CCS-P, CEMC, MHP, serves as an instructor for various HCPro Coding and Medicare Boot Camps and co-developed the Codercise® CPT Operative Report. Dr. Harrington has more than 20 years of experience in the health care profession. She is an approved instructor of the Professional Medical Coding Curriculum, awarded by the American Academy of Professional Coders, and teaches coding for physician and hospital services, as well as health care administration. She has spoken frequently on health care compliance and health information management issues at regional and national professional conferences.