How Do Questions Get Published in the Coding Clinic Newsletter?

4 min read

Have you ever wondered how the AHA Central Office decides which coding questions to publish in the Coding Clinic newsletters? Read more to find out!

Step 1: Question received through the CCA Website 

When a question is submitted to the AHA Central Office through the Coding Clinic Advisor website, it enters our internal database, where the team reviews the question. This internal review process involves research by our team of experts. How do we research questions? We look at previously published advice in Coding Clinic for HCPCS or Coding Clinic for ICD-10-CM and ICD-10-PCS, and we also review previous decisions from our Editorial Advisory Board (EAB) meetings. (More on the EAB later!) For HCPCS questions, we consult CPT Assistant and CPT Guidelines.  

Sometimes, our internal team cannot come to a consensus and answer the question. There are several reasons this might happen:

1. The team members have a difference of opinion.
2. There is no clear-cut answer in the guidelines or code descriptors.  
3. Multiple coding professionals are submitting the same question.  

If no consensus can be reached, then we move on to step 2.

Step 2: Determine if the issue should be presented to the EAB.

“EAB” stands for “Editorial Advisory Board,” and there are two EABs: one for HCPCS, and one for ICD-10-CM and ICD-10-PCS. The EABs consist of representatives from the following organizations:

• Center for Medicare & Medicaid Services (CMS) 
• Centers for Disease Control and Prevention (CDC) National Center for Health Statistics
• American Medical Association (AMA) 
• American Health Information Management Association (AHIMA) 
• American Hospital Association (AHA) 
• Coding professionals representing several hospitals and other institutions

Each EAB meets quarterly to discuss coding questions the AHA Central Office presents. The AHA Central Office works closely with all members of the EAB to determine how they will answer the specific question being presented.  

Step 3: Decide Which Question to Publish in Coding Clinic

The EAB collectively determines which issues will be published in the Coding Clinic newsletter. We only publish questions that have been through the EAB process and approved for publication by the EAB; and not every issue reviewed by the EAB is an ideal candidate for publication.  

One More Thing!  

Remember! The advice published in Coding Clinic for HCPCS and Coding Clinic for ICD-10-CM and ICD-10-PCS is developed in collaboration with all members of the EAB, and is based on specific supporting medical record documentation, and determined to be the correct advice at that point in time in accordance with coding guidelines. We realize that over time coding advice may change and, when that occurs, the most current advice should be followed.

If you would like to read more about our processes, please consult “Facility Reporting and the Central Office on HCPCS” (Coding Clinic for HCPCS, Fourth Quarter 2021) and “Requests for Publication in Coding Clinic for HCPCS (Coding Clinic for HCPCS, First Quarter 2024).