Chapter 13 Application Exercise- Erica Flores.docx - Audit...

Audit Results Report and Analysis
Recently our coding team underwent an audit of 100 inpatient admissions. These 100
admissions were selected at random. Overall, the team accuracy was 84%. We know that our
goal is to be at 95% or better. We have some work to do to improve this percentage. It is highly
important that our team is performing at a higher accuracy rate to ensure compliance with coding
procedure and regulations, correct billing and to get the full and accurate reimbursement. The top
three areas of concern are missing secondary diagnosis (SDX), missing prognosis (PX), and
incorrect primary diagnosis (PDX). In the following paragraphs, I’d like to discuss how the
individual coders performed and a plan for improving the performance for those who did not
meet the standard accuracy of 95%.
First, let’s discuss the individual performance percentages. Coder A had 20 cases under
the audit. Out of the 20, 5 had issues. This puts their performance accuracy at 75%. There is a lot
of need for improvement here. Coder B had 20 cases under the audit and 4 had issues. Coder B’s
performance accuracy is 80%, again, leaving room for plenty of improvement along with coder
A. Coder C had 20 audit cases and there were no issues detected here. This is an outstanding