A Team-Based Learning Approach to
Reimbursement and Billing Education for
Emergency Medicine Residents
Anisha Turner ( )
Baylor College of Medicine
Alison Haddock
Baylor College of Medicine
Sara Andrabi
Baylor College of Medicine
Richina D. Bicette
Baylor College of Medicine
Theresa Tran
Baylor College of Medicine
Cedric Dark
Baylor College of Medicine
Research Article
Keywords: team-based learning, billing and coding, reimbursement
Posted Date: August 3rd, 2022
DOI: https://doi.org/10.21203/rs.3.rs-1889511/v1
License: This work is licensed under a Creative Commons Attribution 4.0 International License.
Read Full License
Page 1/13
, Abstract
Objective: We developed a curriculum to improve resident knowledge and comfort in charting and coding
during emergency medicine (EM) encounters. Our tool kit includes simulated charts and assessments in a
team-based learning (TBL) format. Settings: The curriculum was delivered at one an academic
institution’s emergency medicine program. Participants: Thirty-one residents and 18 faculty and APP
learners attended the TBL reimbursement workshop. Primary and secondary measures: Learners
perceived knowledge and comfort in charting and coding Results: The response to the TBL exercise was
overwhelmingly positive, with an increase in learner’s comfort with understanding and placing the 6
different evaluation and management Current Procedural Terminology codes commonly used in EM
signi cantly increasing. The learners also had a signi cant increase in distinguishing between new (e.g.,
alternative payment systems) and older (e.g., fee-for-service) payment systems had a signi cant 30-point
increase (p<0.001). Conclusions: This study demonstrates that TBL can successfully be used as part of
EM residency curriculum to teach charting and coding skills. Our TBL exercise demonstrated signi cant
gains in self-rated knowledge for the three learning objectives pertaining to EM reimbursement.
Introduction
The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of
residents understanding charting and coding by promoting educational activities involving charting and
coding in the core competency “system-based practice (SBP).” 1 Competency in SBP requires that
residents “demonstrate an awareness of and a responsiveness to the larger context and system of health
care.” 2 Despite this including charting and coding skills, numerous studies suggest a need for improved
education in the area, with one study showing that only 15% of residents understand what an
Evaluation/Management (E/M) code is and 74% felt they did not receive adequate education in charting
and coding skills during residency. skills.2,3,4,5
While institutions have used multiple pedagogical approaches, the best method for teaching charting and
6,7
coding is unknown. To address the lack of a standardized charting and coding educational method at
our institution, we incorporated charting and coding skills in our health policy curriculum. In this paper,
we detail the development and formalization of resident charting and coding curriculum, as well as
measure the effectiveness of our approach to improving resident knowledge and comfort of charting and
coding emergency medicine (EM) encounters.
Methods
Patient and Public Information
No patient involved.
Curricular Design
Page 2/13
Reimbursement and Billing Education for
Emergency Medicine Residents
Anisha Turner ( )
Baylor College of Medicine
Alison Haddock
Baylor College of Medicine
Sara Andrabi
Baylor College of Medicine
Richina D. Bicette
Baylor College of Medicine
Theresa Tran
Baylor College of Medicine
Cedric Dark
Baylor College of Medicine
Research Article
Keywords: team-based learning, billing and coding, reimbursement
Posted Date: August 3rd, 2022
DOI: https://doi.org/10.21203/rs.3.rs-1889511/v1
License: This work is licensed under a Creative Commons Attribution 4.0 International License.
Read Full License
Page 1/13
, Abstract
Objective: We developed a curriculum to improve resident knowledge and comfort in charting and coding
during emergency medicine (EM) encounters. Our tool kit includes simulated charts and assessments in a
team-based learning (TBL) format. Settings: The curriculum was delivered at one an academic
institution’s emergency medicine program. Participants: Thirty-one residents and 18 faculty and APP
learners attended the TBL reimbursement workshop. Primary and secondary measures: Learners
perceived knowledge and comfort in charting and coding Results: The response to the TBL exercise was
overwhelmingly positive, with an increase in learner’s comfort with understanding and placing the 6
different evaluation and management Current Procedural Terminology codes commonly used in EM
signi cantly increasing. The learners also had a signi cant increase in distinguishing between new (e.g.,
alternative payment systems) and older (e.g., fee-for-service) payment systems had a signi cant 30-point
increase (p<0.001). Conclusions: This study demonstrates that TBL can successfully be used as part of
EM residency curriculum to teach charting and coding skills. Our TBL exercise demonstrated signi cant
gains in self-rated knowledge for the three learning objectives pertaining to EM reimbursement.
Introduction
The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of
residents understanding charting and coding by promoting educational activities involving charting and
coding in the core competency “system-based practice (SBP).” 1 Competency in SBP requires that
residents “demonstrate an awareness of and a responsiveness to the larger context and system of health
care.” 2 Despite this including charting and coding skills, numerous studies suggest a need for improved
education in the area, with one study showing that only 15% of residents understand what an
Evaluation/Management (E/M) code is and 74% felt they did not receive adequate education in charting
and coding skills during residency. skills.2,3,4,5
While institutions have used multiple pedagogical approaches, the best method for teaching charting and
6,7
coding is unknown. To address the lack of a standardized charting and coding educational method at
our institution, we incorporated charting and coding skills in our health policy curriculum. In this paper,
we detail the development and formalization of resident charting and coding curriculum, as well as
measure the effectiveness of our approach to improving resident knowledge and comfort of charting and
coding emergency medicine (EM) encounters.
Methods
Patient and Public Information
No patient involved.
Curricular Design
Page 2/13
