Clinical Edge

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Should Medical Coding Be Taught During Residency?

J Drugs Dermatol; 2018 Jun; Blecher, Halverstam, et al

Due to frequent changes in medical coding systems, billing for outpatient visits through evaluation and management (E&M) services has become increasingly complicated. As a result, physicians often bill improperly, costing the US health care system billions of dollars annually. According to a recent study, however, many dermatology residents were able to correctly answer questions that tested their basic knowledge of E&M coding. In this analysis, a questionnaire was distributed to dermatology programs in the US consisting of questions pertaining to didactic education for, experience with, and resident knowledge of medical coding and billing. Researchers found:

  • 138/443 dermatology residents participated (31.2% response rate).
  • 79% of residents reported receiving some type of formal training.
  • Nearly 89% reported personally billing patient visits to some degree, with 41.3% billing for 100% of outpatient visits.
  • >75% of residents were able to answer basic billing questions and 70% correctly billed a patient visit when given a complex clinical scenario.
  • Despite these results, only 37% of residents reported feeling confident in their billing abilities.
  • Lastly, 94.9% of respondents believed medical coding and billing should be integrated into dermatology training curriculums.


Blecher K, Halverstam C, Rzepecki AK, McLellan BN. A national survey of medical coding and billing training in United States dermatology residency programs. J Drugs Dermatol. 2018;17(6):678-682.