Leverage That Listserv with Caution

Karna W. Morrow, CPC, RCC, CCS-P, PCS
Senior Consultant, CSI Coding Strategies, Inc, Powder Springs, GA

In an ideal practice management world, every unique coding situation would be carefully explained within the American Medical Association (AMA) Curent Procedural Terminology (CPT) codebook or within the CPT Changes: An Insider’s View manual. The rules for coding and compliance would be black and white, and they would be applied consistently from insurance payer to insurance payer.

Unfortunately, we don’t live in an ideal world, and as such, Listservs that focus on coding, billing, compliance, practice management, and other relevant topics have become familiar and helpful tools within the oncology coder’s arsenal of reference materials. The network of experience provided on these Listservs is invaluable, and practice managers frequently turn to them for tips and best practices.

Even when posting to a private forum though, it is important to keep in mind that the information provided or the question asked is, in fact, public. For most employees, an electronic signature on an e-mail is the equivalent of a business card, complete with the person’s position and contact information. Here are several things to keep in mind when posting questions and/or answers in a public forum:

  1. As a general rule, familiarize yourself with each Listserv’s published guidelines, as well as the rules, regulations, and etiquette that govern use of a particular Listserv before you make any posts. In addition, all Internet communications should always have one more read-through before they are sent.

  2. Who is getting the message? Do more than just confirm that the correct mailing list address shows in the “Send to” field. Even though you should never forward inquiries from other individuals to a Listserv without their permission, would you want anyone and everyone to see the question or response posted? Are you comfortable with the message being forwarded to someone else, to another Listserv, or to your supervisor? Would you want the information in the post linked to your organization and viewed by a payer representative, an investigator from the Office of Inspector General, or an FBI agent?

  3. Have you admitted in your post that current coding practices might not be consistent with common practices or established guidelines? Instead of asking about how to code something, consider asking about coding guidelines or reference tools for coding for a particular topic. The Listserv may not be the best place to say, “We always bill nonphysician provider services under the physician, even if the individuals are employed by the hospital. Is that ok?”

  4. If you want solid guidance from a Listserv, you need to draft a solid question. Consider writing questions with sufficient information that will help you and others learn how to apply authoritative guidance for unusual situations. Resist the urge to cut and paste from a medical record and lead the subject line with the phrase, “Help Please.” See the Checklist for some questions to ask yourself before posting.

  5. Remove all information or data that are not relevant to the discussion, as a courtesy to fellow readers and in consideration of Health Insurance Portability and Accountability Act guidelines. It is rarely necessary to include an entire progress note. Everyone will appreciate it if you jump right to the relevant parts, especially those who are reading on a smartphone or mobile device.
One benefit to working in healthcare is the endless opportunity to learn. Although the saying “We’ve always done it that way” is a cliché, every year new codes, guidelines, and procedures encourage us to continue learning. As we approach 2015 with a fresh batch of new codes and guidelines, use Listservs to learn. If your questions require more detail than you are comfortable sharing online, or if the case requires sharing actual content from a medical record, consider privately e-mailing one of the members of the Listserv or an administrator of the Listserv. If consulting advice is needed, an administrator can point you in the right direction.

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