I have over five years of experience in outpatient surgery and ambulatory coding. I have worked with various EHR systems, ensuring accurate and timely coding for surgical procedures and outpatient services. My experience includes coding for minor surgeries, endoscopies, and other ambulatory procedures, adhering to ICD-10 and CPT guidelines. I have also participated in audits and quality improvement initiatives to ensure compliance and reduce denials.

I regularly attend coding seminars, webinars, and workshops to stay current with the latest coding guidelines and regulations. I also subscribe to coding journals and participate in professional organizations such as the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Additionally, I review CMS updates and participate in online forums to discuss changes and best practices with my peers.

My process involves thorough documentation review to ensure all necessary information is present. I cross-reference patient records with operative reports and diagnostic tests to verify accuracy. I also maintain open communication with physicians to clarify any ambiguous information. By following these steps, I minimize the risk of coding errors and claim denials, ensuring timely reimbursement and compliance with regulatory standards.

When discrepancies arise, I first review the coding guidelines to ensure I have a clear understanding of the requirements. I then communicate with the physician to clarify any ambiguities or missing information. If necessary, I document the discrepancy and escalate the issue to the appropriate department for resolution. My goal is to ensure accurate coding while maintaining strong physician relationships.

One challenging scenario involved a complex outpatient procedure with multiple diagnoses and procedures. The physician's documentation was incomplete, and I had to request additional details to ensure accurate coding. After several follow-ups, I received the necessary information and was able to code the procedure correctly. This experience reinforced the importance of thorough documentation review and effective communication with healthcare providers.