SHM Converge Scientific Abstract ePoster Gallery-So You Think You Can Code?

Pdf Summary

This project addressed widespread inpatient coding inaccuracy in hospital medicine, a problem often driven by limited training and heavy reliance on complex MDM-based coding. The consequences include lost revenue, staffing inefficiencies, and increased audit risk. At the authors’ institution, baseline coding accuracy was only 51%, creating significant financial and compliance concerns.<br /><br />To improve performance, the team designed a simplified, longitudinal, case-based, time-focused coding curriculum for hospitalists. The interprofessional implementation team included a physician coding champion, an administrator, and a billing and coding specialist. Key tools included single-slide summaries for each code with time thresholds and requirements, vetted EHR dot phrases, and real-time support from a billing and coding specialist during education sessions.<br /><br />The intervention shifted clinicians toward time-based coding and emphasized practical, engaging education rather than dense coding rules. Results were strong: audit accuracy increased from 51% to 93% between 2023 and 2025. The program also improved use of newer and existing billing codes, including 99418 and 99291, and increased work RVUs by 22%, generating more revenue than would be expected from CMS changes alone.<br /><br />The authors conclude that a simple, interprofessional, time-based coding curriculum can substantially improve coding accuracy, reduce compliance risk, and better align provider work with institutional value without increasing patient volume. They note, however, that barriers remain, including scarce coding education resources tailored to hospital medicine, resistance to changing established practice patterns, and the need to sustain gains through continued investment and education.

Asset Subtitle

Warren Gavin

Meta Tag

Author List Areeba Kara, C'Aira Hermesch, Jake Gibbs MBA, Jason Russ, Warren Gavin

Category Innovations

Concept Inpatient Coding

Concept Time-Based Coding

Concept Coding Education Program

Concept Financial Loss

Concept Audit Risk

Distinguished Non-Finalist

Presenter Organization Indiana University School of Medicine

Presenting Author Warren Gavin

Track Value in Hospital Medicine

Keywords

inpatient coding

hospital medicine

coding accuracy

time-based coding

medical decision making

billing and coding

audit risk

revenue improvement

interprofessional education

work RVUs

Inpatient Coding

Time-Based Coding

Coding Education Program

Financial Loss

Audit Risk