Practice Management

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  • 1.  Coding Audits

    Posted 11-04-2022 10:10

    When performing diagnostic and interventional radiology coding audits, is there an accepted industry standard for statistically valid sample sizes of total accessions reviewed?

     

    Thanks,

    John

     

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        John E. Pugh

     P:  609.644.4479

     F:  609.503.2476

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  • 2.  RE: Coding Audits

    Posted 11-04-2022 12:21

    John – Others may have a different response but for me it is about establishing the confidence of the accuracy of the audit. You can establish a 60% confidence that the audit is statistically significant up to 99% confidence. I usually shoot for 80%. Once that confidence level has been set it's a simple calculation knowing the "n" or number of charts there are to audited and then pulling up a "t" Table and calculate the numbers of charts to audit to hit the confidence level you wish to achieve.  Granted I was a bit more picky when I was doing audits because I wanted to be able to make a statement that that I was XX% confident that the dictations met compliance requirements for coding, etc. The Radiologists always seems very appreciative of that effort and when you included the t-tail calculations in the report they knew exactly what was done and why.... Hope that helps.....

     

    Keith E. Chew, MHA, CMPE, FRBMA

    Principal

    Consulting with Integrity

    18 Hawks Nest

    Chatham, IL     62629

    217-971-5293

     






  • 3.  RE: Coding Audits

    Posted 11-05-2022 11:38
    Edited by Harry Curley 11-05-2022 11:38
      |   view attached
    John, I've attached a sample size calculator that we use when performing random sample audits.  

    This is also a helpful online link with calculator.  https://compliance-master.com/compliance-sample-size-calculator/

    Hope this is helpful.

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    Harry Curley
    CEO
    StreamlineMD, A PRC Medical Company
    hcurley@streamlinemd.com
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    Attachment(s)



  • 4.  RE: Coding Audits

    Posted 11-05-2022 13:24
    Thanks, Harry. 

    John E. Pugh
    Pugh Healthcare Business Advisors
    609-644-4479