A national survey of medical coding and billing training in United States dermatology residency programs

Background: Due to frequent changes in medical coding systems, billing for outpatient visits through Evaluation and Management (E & M) services has become increasingly complicated. As a result, physicians often bill improperly, costing the United States health care system billions of dollars annually. Despite the importance of proper documentation, medical coding and billing is largely ignored during residency training. Objective: Assess the exposure to and quality of medical coding and billing training in dermatology residency programs. Methods: A questionnaire was distributed to dermatology programs in the United States consisting of questions pertaining to didactic education for, experience with, and resident knowledge of medical coding and billing. Results: 138/443 dermatology residents participated (31.2% response rate). 79% of residents reported receiving some type of formal training. Nearly 89% reported personally billing patient visits to some degree, with 41.3% billing for 100% of outpatient visits. Over 75% of residents were able to answer basic billing questions and 70% correctly billed a patient visit when given a complex clinical scenario. Despite these results, only 37% of residents reported feeling confident in their billing abilities. Lastly, 94.9% of respondents believed medical coding and billing should be integrated into dermatology training curriculums. Conclusions: The majority of dermatology residents have opportunities to learn medical coding and billing through didactics and clinical experiences. Many residents were able to answer correctly questions that tested their basic knowledge of E&M coding. These results are encouraging and reflect the recognition of the importance of medical coding and billing training during residency.