University of Michigan Health-Sparrow

Medical Billing and Coding

• Review medical record documentation and assign ICD-10-CM, ICD-10-PCS, MS-DRG, and APR-DRG codes
• Extract, review, analyze, and abstract clinical and facility-required data
• Translate clinical data into codes for hospital billing, POA and PSI indicators, research, statistics, financial planning, compliance, and marketing
• Verify patient discharge disposition and assign appropriate present on admission (POA) indicators
• Determine case complexity using clinical knowledge of diseases, procedures, diagnostics, treatment, and prognosis
• Research complex diagnoses and procedures to apply correct coding
• Capture principal diagnosis, co-existing conditions, and principal procedure for inpatient admissions
• Collaborate with CDI specialists and DRG compliance auditors to query providers and clarify documentation
• Sequence codes to accurately capture Severity of Illness and Risk of Mortality
• Follow official coding guidelines, AHIMA ethics, AHA Coding Clinics, CMS directives, and regulatory requirements
• Utilize Optum CAC according to established workflow
• Maintain coding accuracy, quality, productivity, and performance standards
• Attend required meetings, in-services, educational sessions, and annual learning programs

Inpatient Coder