33455 Utilizing a residency manual to improve dermatology residents’ accuracy in billing, coding, and order placement

Abstract

Background: New residents unfamiliar with dermatology codes can take additional time to input orders, costing clinic valuable time and money. Resident coding and billing errors persist into PGY-4 and occur in as many as 7.6% of orders based on a standard dermatology clinic. Objectives: To evaluate if a custom orientation handbook outlining billing and procedure codes helps to decrease the number of Epic errors made by SLU dermatology residents. Methods: An evidence-based handbook with stepwise instructions for navigating Epic orders and coding was created and disseminated to all SLU dermatology residents in July 2020. Residents and attendings were surveyed about handbook use and error prevention. SLUCare Clinical Informatics Operations Manager comparison of July 2020 to July 2019 was obtained to assess number of errors corrected. Results: In July 2020, the handbook was referenced daily most frequently by first-year dermatology residents. Attending physicians corrected LOS or other codes on average less frequently in July 2020 compared with July 2019. Nine of nine (100%) resident respondents and 5 of 5 (100%) attending respondents replied “Definitely yes” to continuing to have this resident handbook for future years of incoming residents. Billing and coding errors statistically significantly decreased from July 2019 to July 2020 (P = .01). Discussion: The resident handbook was found to be helpful by both attendings and residents, and was a successful tool in reducing resident errors in billing and coding. Such an intervention can be useful in a clinical setting to boost efficiency and timeliness of patient care.