Eric L. Altschuler, MD
In addition to the clinical skills lectures included in medical school curriculum, second-year medical students at Rutgers New Jersey Medical School in Newark, NJ, are also receiving a course in understanding the basics of billing and coding, referred to as Evaluation and Management (E&M) services by the Centers for Medicare & Medicaid Services (CMS). Details about the pilot program, published in Medical Education Online
, include four 1-hour lectures about E&M billing and coding with a focus on three skills that can be billed to CMS: taking a medical history, performing a physical examination, and medical decision-making.
Introducing the courses during the second year of education “definitely fits into the curricula objectives in medical education,” says coauthor, Eric L. Altschuler, MD, associate professor of Microbiology & Molecular Genetics in the Department of Physical Medicine and Rehabilitation at the medical school. The original plan was to give the first two lectures in the fall and the remaining two lectures near the end of the second year. However, Hurricane Sandy prevented the latter lectures—they were postponed until near the end of the clinical skills course.
While student responses were generally positive, the short-term and long-term effectiveness of the courses remains to be seen, said the authors. The researchers said that measuring more advanced skills—“such as those involved in the ‘art’ of actual coding”—may require more complex testing, and could include the use of mock billing scenarios.
“We’re looking to submit a grant for further rollout,” said Altschuler.
The authors caution that introducing this type of coursework could hasten declines in empathy across the curriculum, most likely because the burden of paperwork needed to comply with practice requirements is a primary driver of health care costs. In addition, the authors said that the amount of administrative burden associated with the current health care delivery system makes it the least desirable aspect of practicing medicine.
Educating students about proper billing and coding techniques is a necessary part of practicing medicine, said the researchers. The relatively small amount of curricula needed to cover the subject may prove to be a beneficial skill, conclude the authors.
Source: Tran J, Cennimo D, Chen S, Altschuler EL. Teaching billing and coding to medical students: a pilot study. 2013. Med Educ Online
. 18:21455. doi: 10.3402/meo.v18i0.21455.