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Compatible with: Palm OS PDA's (Treo, PalmOne) or Windows Mobile Pocket PC (Dell, iPAQ, etc.) using the StyleTap Platform |
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Featured in:
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What does the three digit code at the top of the screen signify?They are the last three digits of the evaluation and management (E&M) procedural codes, i.e. 99XXX. Back to TopWhere are the instructions?There are operating instructions as well as extensive documentation guidelines contained within the software. They are available via the MENU button. They are included entirely in the software so that clinicians who receive STAT E&M Coder via infrared beaming can view them. There is also extensive documentation from the CMS 1997 Evaluation and Management coding guidelines available by tapping the bold category headers. Back to TopWill STAT E&M Coder work with a Mac?Yes, since there is no PC conduit, this software can be installed just like any other Palm software from a Mac via the standard install tools. Files in .zip format will require an appropriate decompression utility for the Mac such as Stuffit from Aladdin Systems. Back to TopHow do I hold a dictation machine, Palm OS unit, and the stylus with only two hands?Some clinicians dictate into a phone using a shoulder rest. This leaves both hands free. Others use a lapel microphone, headset, voice-activated tape recorder, or a foot triggered recorder. Since no graffiti input is required, the reverse end of a pen works nicely as a blunt stylus. The handheld can also be propped up in some way. Back to TopI'm getting errors when I try to download the eandm.prc fileSome browsers (Netscape) do not work correctly when you try to directly install a ".prc" file. In this instance, download the eandm.zip file. You will need an unzip utility such as Winzip. Click here to view articles about downloading and installing Palm OS software. Back to TopWhat specific coding guidelines are used?CMS 1995 and 1997 Documentation Guidelines for Evaluation and Management Services. Clinicians currently have the option of using 1995 or 1997 guidelines. The 1997 guidelines are more specific and are the first ones to contain specific history, exam, and medical decision making "bullets." See the sections below about potential changes to the E&M guidelines. Back to TopI thought that the new E&M guidelines were put on hold. Why can't I wait until they come out with the final guidelines?Development of a new framework for E&M coding is still pending with no specific schedule for implementation. E&M continues to be a primary auditing target by CMS and other payers. From The Physician Practice Compliance Report (May 1999):
If you don't know what you are doing, you are probably either overcoding or undercoding consistently. Both have adverse financial implications for your practice. Some examples of recent E&M coding issues:
As noted above, some insurers have been reviewing office visit documentation, realizing an opportunity to downcode 90% of Level 4 and Level 5 claims. E&M coding, largely viewed as a compliance issue, is now a revenue issue. Not convinced yet? Then, read the June 2000 "Dear Medicare Physician" letter stating, specifically, that HCFA will be focusing on two E&M codes, 99214 (established patient office visit Level 4) and 99233 (inpatient follow-up, highest level). According to CMS, many of these services were only found to be sufficient to support 99212 and 99231 respectively (downcoded two levels). Back to TopWill this software be updated to include the new E&M guidelines when they are introduced?Yes Back to TopDoes STAT E&M Coder integrate with charge-capture systems?No Back to TopWill this software prevent an audit?No. Most audits will be triggered by individual coding distributions which fall significantly outside of the norm. However, successful defense of an E&M audit depends on documentation which supports the level of coding submitted. All evidence indicates that third-party payers of all kinds are increasing their auditing of E&M codes. In fact, the latest technique is to select physicians who code level 4 and 5 visits too often and then ask for documentation for every visit coded at these two levels. Preliminary reports show that about 90% of these claims end up being downcoded because the documentation failed to support the coding level billed or was never submitted for review. Back to TopHow does STAT E&M Coder create audit records?The clinician, at any time, can select <MENU> <Save Memo> which will prompt the user for various identification fields. A Palm memo file will then be created that can be read on handheld and will automatically transfer to the desktop memo application (such as Palm Desktop or Outlook) upon the next HotSync. Here is an example:
Back to TopHow safe is this tool to use from a fraud and abuse standpoint?
Back to TopWhat about that service or software that does the coding for me?That option saves the clinician from having to learn anything about documentation requirements and will ensure compliance with documentation guidelines. However, it is lacking the real-time feedback which is useful in guiding the clinician to document more efficiently. So, your dictation comes back saying that you missed a level 4 visit because you neglected to document two more bullet points. Now what? Better luck next time? Perhaps it can be likened to handing all of your financial records to your accountant in the Spring saying "figure out how much I owe" without any prior thought or planning. Also, unless you do all of your E&M services in one setting, you will not have other software available to you at all times. Furthermore, the OIG Work Plan 2000 contains the following statement about automated encoding software: We will determine whether errors found in Medicare billings for physician services are associated with providers' use of automated encoding software. We will also examine billing processes to identify vulnerabilities that occur when physician offices bill independently or through use of a third party system. The use of STAT E&M Coder by a clinician is transparent to an auditor because all of the documentation comes directly from the clinician's dictation, not the software. How much does STAT E&M Coder cost?STAT E&M Coder costs $75 for a two year license. Registration entitles the user to software updates for two years. Registered users will receive notification of significant software updates via email. Registered users receive a unique code number that unlocks the demo mode and turns off the reminder screens. Back to TopAre volume discounts available?STAT E&M Coder is marketed exclusively via this web site to advanced users of Palm OS handheld computers. Users need to be very familiar with the process of downloading, installing, and maintaining this kind of software. There is a discount offered to large groups who purchase 10 or more licenses at a time and have information technology departments to facilitate technical support internally. Back to TopHow can I get everyone else in my organization to use this to improve their coding?Giving everyone in your organization a handheld is probably a bad idea. Not everyone wants to use a handheld. The primary success factor is the motivation of the user to improve their coding. Most coding tools will require that the user have some basic understanding of the documentation guidelines. Only a small percentage of physicians have even glanced at the guidelines. Then there must be also be a willingness to go through the learning curve it takes to use the tool and improve documentation efficiency. Back to TopHow about other tools that facilitate E&M coding?The ideal coding solution for clinicians should:
Back to TopWhere the GI exam?STAT E&M Coder contains only the exam documentation framework outline by CMS. No specific GI organ system exam was specified. Back to TopIs there a PC version of this software?No. This application is specifically tailored to the Palm OS platform for handheld computers. However, there is a demo that will show this software simulated on a Windows PC. Back to TopWhat is the software developer's clinical/educational background?Andre S. Chen, M.D. is board certified in Family Practice, has received an MBA from the University of Texas at Austin, and practices full-time with a multi-specialty group practice in Austin, Texas. StatCoder.com was founded in 1999. Click here for more information about StatCoder.com Back to TopWhat kind of handheld should I buy?Plan for 8 megs or more for any clinical application. Software from StatCoder.com occupies no more than ` meg in total, however there are there are larger reference applications which no clinician will want to be without. STAT E&M Coder and the other software available from this company will run on even the lowest priced Palm OS handheld. These include handhelds from PalmOne View our compatible PDA page which contains pictures and web links. Back to TopWhat development platform was used to write this software and how hard was it to create?The actual code is written in C. With limited programming experience (i.e. Basic and Pascal), it took the developer (a physician) four months to learn the programming language and produce the first beta version in January 1999. It has been modified constantly since then. Two excellent resources for Palm OS developers are Palm Programming: The Authoritative Solution and Palm Programming: The Developer's Guide. The latter is available to read online here. Back to TopHow can I make this software available to an associate? |
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