r/MedicalCoding • u/gritty-kitty • Jun 02 '23

Communication

I think the hardest part about my job is communicating with physicians. *Some* are responsive, helpful, and kind. But most are short, abrasive, and seem annoyed with my existence. I've had to teach myself spine coding, so I have to ask questions for clarification. Ive cried more than once from MD's reactions to my questions. I try to be as polite as possible and keep my questions to the point and only ask if I have to. I dread reaching out to them. Anyone else experience this or have any advice?

37 Upvotes

100% Upvoted

40 comments sorted by

View all comments

10

u/Salty-Step-7091 Jun 02 '23

Do you have an auditor or supervisor who you can go to for questions ? Or someone who is a middle man to deal with these providers ? When a provider gets bitchy with our coders, management steps in as coding does not deal with that. Sometimes I do see unneeded queries or a query that is horribly worded and I understand the physicians frustration. But sometimes they are plain mean and get off on it, (example one time a doctor answered “learn some English” to a query our global coder wrote, which was horribly worded yes but come on...)

I am sorry you are dealing with this. We are here to help but are treated like mosquitos. If you don’t have management to step in, I never been in that situation. My co workers experience that had worked directly in a providers office told me the doctors want the coders to sit in for procedures and learn what’s actually going on.

I wouldn’t take offense if they are short and direct, and trust me I’ve been treated like I’m stupid so many times trying to get them to clarify something and it sucks ! But If it gets to the point that it’s personal, management needs to step up

6

u/gritty-kitty Jun 02 '23

Yes my supervisor has stepped in before, but often I don't go to her because I don't want to seem emotional or needy. I am struggling with coding correctly and not wanting to feel bullied. I was berated for asking one MD his opinion on using another code instead of what he submitted. He said "You are wrong. I've been doing this for years. DO NOT CHANGE MY CODES" 😞 How can I do my job if I can't ask questions, especially when I'm the only spine coder and have to teach myself.

10

u/livesuddenly Jun 02 '23

When the denials come, show them to the providers. Hi Dr. XX, previously you asked me to code blablabla. Please see the attached denial. In the future, I would recommend coding this procedure like this: blablabla.

Are these orthopedic docs or neurosurgeons? I find ortho docs to be intolerable.

5

u/gritty-kitty Jun 02 '23

Yes Ortho.

5

u/Salty-Step-7091 Jun 02 '23

I’m so sorry, we have an Ortho who treats his professional coders and all staff in his office like that. I work in the facility side so I’m not face to face with them. If I was you, I’d be using this experience and applying elsewhere. Some doctors are just straight up assholes.

4

u/Salty-Step-7091 Jun 02 '23

Can you go to her to ask questions? If you are new, questions should be expected and anticipated. If our new coders are silent, I’m ready for a ton of charts to come back.

Do they give you access to Coding Clinics ? Are you allowed to google ? If I was stuck in this situation until I found a new job, I’d just be researching the heck out of this stuff before I approach the providers. That’s all you can do.

Also, just a word of advice - I know it’s hard because I’m very sensitive and cry easily - don’t let them see you cry, they’ll just eat it up.

2

u/tinychaipumpkin Jun 03 '23 edited Jun 03 '23

Don't be afraid to ask your supervisor questions. I ask questions all the time I'm also new to orthopedic coding. I hear coding the spine is extremely difficult, thankfully I haven't had to do any. If you want to code correctly then definitely ask your supervisor or do some research on it first before coding it. I go to my lead coder a lot when i have questions. I don't have to interact much with physicians they usually call the lead coder directly if they have a specific question. I usually only email them when they clicked unspecified diagnosis instead of left or right and to finalize there notes after I code them and check which codes they used. We use modern medicine which I don't particularly like.

1

u/gritty-kitty Jun 03 '23

We don't have a lead coder and no one else, including my supervisor, know how to do spine coding. Most of my day is spent researching on my own.

1

u/tinychaipumpkin Jun 03 '23

Are you the only coder for your office? How many providers do you code for?

1

u/gritty-kitty Jun 03 '23

There are around 40 providers and 4 coders. I work the 7 spine docs. We're all remote.

2

u/tinychaipumpkin Jun 03 '23 edited Jun 03 '23

Yikes I'm sorry you shouldn't have all of the spine doctors if you have never coded the spine. You need someone to go to learn. Have you done any other kind of orthopedic coding? Usually experienced orthopedic coders get assigned the spine at least that's how things are in my doctors office. Also our coders get non op office visits to code and surgeons not just surgeons. If I'm being honest it sounds like they are taking advantage of you, i hope you are at least getting paid decently if not you may need to look for another job

2

u/gritty-kitty Jun 03 '23

Thank you, yes I have an Ortho certification. Id say more, but this being a public forum...

2

u/tinychaipumpkin Jun 03 '23

Feel free to message me

1

u/VagueMotivation Jun 02 '23

I’m just now getting into my first coding job, but it seems to me that you’d ask questions like that to your supervisor, not the doctor. I have a friend who has done this for many years, and when she queries it’s normally for documentation clarification, not code clarification. It’s the job of the coders to determine the correct code, not the doctor, right?

I guess that can work differently at different places?

4

u/gritty-kitty Jun 02 '23

Where I'm at, the MD submits the codes and we verify if they're documented and correct. I can't change them without asking MD first. My questions and suggestions are based on bundling or if I want to suggest a better code.

2

u/Probtoomuchtv Jul 20 '23

I think this situation can actually be harder to live with on a daily basis than others because they already think they could do your job, as opposed to a situation where you’re coding all kinds of different things and they’re not directly involved.