Why All Physicians Should Understand Coding
Shalini Shah, MD, MBA
Associate Clinical Professor
Vice Chair, Pain Management
Director, UCI Health Pain Services
University of California Irvine
Insurance industry consolidation. Denials. Prior authorizations. Reduced reimbursement rates. Employment model salary cuts. There are so many threats ahead of us in medicine. This is why I cannot over-emphasize the need for physicians to understand the basic principles of coding, billing, and documentation.
In our practice at University of California Irvine, we realized the importance of learning these concepts and developed a live, 3-day billing and coding seminar for a long weekend. Not only was it time well spent learning about various coding pearls and salary negotiation concepts (eg, how the “RVU” system is designed), but we had a FANTASTIC team-building opportunity to get to personally know each other better and build memories we will keep for a lifetime.
The physicians were able to get answers to their questions on things like the differences in what the Centers for Medicare and Medicaid Services (CMS) allows for genicular diagnostic nerve blocks vs radiofrequency ablation, as just one example. We all ended up with pages and pages of notes.
We didn’t realize how incredibly valuable this conference was going to be. In fact, it was probably one of the best examples of direct value-add to my professional career I have ever experienced. What we all agreed on is the importance of keeping billing and coding in the physicians’ hands, especially as more and more pain physicians are now employed physicians. As health care continues to evolve, I really believe our generation of physicians has to develop these skills under the framework of healthcare economics – and master the nuances of coding, modifiers, and documentation levers that control your income and the health of your practice.
As a fellow physician, I urge ASRA members to participate in the many Practice Management programs that ASRA offers, including the Practice Management Portfolio program held at the annual meetings, the Business Leadership Online Courses (a new one starts August 30!), and an upcoming Hot Topics on Practice and Business Management being held on July 13th in conjunction with the Association of Pain Program Directors.
In addition, check out ASRA Coder, an app for iPhone and Android that helps you find CPT codes and instructions for commonly used procedures for management of acute and chronic pain. The app is updated annually to match the latest CMS data.
Finally, ASRA’s Practice Management Resource Center including a Practice Management Lexicon, is also available to help you navigate important terminology and concepts that will help you maintain and grow your practice.