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the only prerequisite for self-audits is having a good grasp of your coding and billing procedures before you implement the process. physicians in our group use superbills to do their own diagnosis and procedure coding at the time of service so they already had a good grasp of coding and documentation. we held a special one-hour training session for our providers to explain the peer-review process, discuss the purpose of a self-audit and perform a sample chart review. the remainder of the session is devoted to a group discussion of the charts and the providers’ coding practices.
for example, a physician with a pattern of under-coding may be asked to review the appropriate cpt or icd-9 codes, as well as the documentation guidelines, to strengthen his or her coding skills. issues and problem areas identified in a self-audit may help determine the scope of the next round of auditing. for example, if you are concerned about the proper documentation and coding for office visits that involve both e/m services and a procedure, you can target those visits only. our practice has found that using peer review in our self-audits of medical record documentation and coding is efficient, cost-effective and educational. visit the fpm covid-19 collection for answers and ongoing updates.
the medical staff peer review committee is responsible for developing and one or two case reviews if the quality of care score is 5b or 6b (see above form). cases are screened by a quality nurse reviewer who generates the medical staff peer review form. the. department/committee/cpg chair is assigned the initial – a member of the medical staff requested to perform peer review may have a conflict of interest and appendix b: case review rating forms., joint commission peer review requirements, joint commission peer review requirements, physician peer review triggers, medical peer review software, fqhc peer review policy.
– sample peer review forms for anesthesia, physician reappointment, quality improvement and more. the peer review process includes – on a monthly basis, one of 17 physicians at orthopedic surgery center of orange county in newport beach, calif. , is chosen to peer review 30 we began self-audits in response to our university medical center’s requirement for periodic record reviews. our first step was to form a departmental compliance , medical peer review services, psychiatry peer review form, psychiatry peer review form, behavioral health peer review form, peer review patient safety
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