Orthopedics. 2020 Nov 1;43(6):380-383. doi: 10.3928/01477447-20200827-10. Epub 2020 Sep 3.
The goal of training in orthopedic residency is to produce surgeons who are proficient in all aspects of the practice of orthopedic surgery; however, most residents receive either inadequate or no training in medical coding. The purpose of this study was to determine how well orthopedic residents code when compared with practicing surgeons and to identify whether coding education improves accuracy in medical coding. A mock coding survey was developed using commonly encountered orthopedic clinical scenarios. The survey was distributed to orthopedic trainees post-graduate years (PGY) 1 to 6 at 2 training programs and to attending surgeons. Results were analyzed in 3 groups: junior residents (PGY 1-3), senior residents (PGY 4-6), and attending surgeons. Overall and subcategory scores of (1) type of visit, (2) modifiers, (3) Evaluation and Management (E/M), and (4) Current Procedural Terminology code identification were recorded. Participants were also asked if they had ever received various forms of coding education. Sixty-seven total participants were enrolled, including 28 junior residents, 24 senior residents, and 15 attendings. Practicing surgeons performed significantly better than both senior (P<.027) and junior (P<.001) residents in all categories, with a mean overall correct response rate of 72.8%, 51.0%, and 47.4%, respectively. Any form of coding education was associated with a significantly improved overall score for residents (P=.013) and a nonsignificant increase for attending surgeons (P=.390). This study demonstrates that residents performed poorly when identifying proper billing codes for common procedures and encounters in orthopedic surgery. Further, those participants who received coding education did better than those who did not. [Orthopedics. 2020;43(6):380-383.].
骨科住院医师培训的目标是培养全面掌握骨科手术实践的外科医生；然而，大多数住院医师接受的医学编码培训不足或根本没有接受过培训。本研究旨在确定与执业外科医生相比，骨科住院医师的编码水平如何，并确定编码教育是否能提高医学编码的准确性。使用常见的骨科临床情况开发了模拟编码调查。该调查分发给 2 个培训项目的住院医师 1 至 6 年后和主治医生。结果分析分为 3 组：初级住院医师（PGY1-3）、高级住院医师（PGY4-6）和主治医生。记录了（1）就诊类型、（2）修饰符、（3）评估和管理（E/M）和（4）当前操作术语代码识别的总体和子类别得分。参与者还被问及他们是否接受过各种形式的编码教育。共有 67 名参与者，包括 28 名初级住院医师、24 名高级住院医师和 15 名主治医生。执业外科医生在所有类别中的表现均明显优于高级住院医师（P<.027）和初级住院医师（P<.001），总体正确反应率分别为 72.8%、51.0%和 47.4%。任何形式的编码教育都与住院医师整体评分的显著提高相关（P=.013），而主治医生的评分则略有提高（P=.390）。本研究表明，住院医师在确定骨科常见手术和就诊的适当计费代码方面表现不佳。此外，接受编码教育的参与者比未接受教育的参与者表现更好。[骨科。2020;43(6):380-383.]。
