Coding Education in Obstetrics [22B]

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Healthcare is continuously evolving and very few trainees understand the principles of ICD diagnosis and procedure coding. Few academic programs incorporate documentation, coding and reimbursement training into medical education. We sought to characterize those trainees with self-reported familiarity and understanding of billing and coding in obstetrics. We also identify challenges and strategies for implementing coding education during residency and fellowship.


Maternal Fetal Medicine fellows, identified through the Society for Maternal Fetal Medicine, were asked to complete an electronic, web-based survey.


Of 72 respondents, 36 (50%) were currently in their third year or were recent graduates of fellowship training. 23 (32%) received formal training during their residency or fellowship, however 30% of fellows reported unfamiliarity with E&M and ICD coding. A significant number of trainees (63%) were unaware of the use of modifiers and how they influence acceptance or rejection of medical claims. 93% (67/72) reported an interest in coding education. Challenges cited include lack of awareness during training, time constraints and financial limitations in participating in additional courses.


With the universal implementation of electronic medical records and the adoption of ICD-10 in the United States, it is imperative that knowledge of appropriate coding and billing practices be upheld. Despite increased utilization of electronic medical records and professional coders, it is important for physicians to have a keen understanding of documentation and coding in clinical practice. These preliminary findings suggest that the current generation of trainees would benefit from coding and billing education during their residency or fellowship curriculum.

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