Compliance with billing and coding rules put forth by the Health Care Finan
ce Administration (HCFA) is a challenge for practicing physicians, includin
g those in academic settings. The authors, members of the academic practice
at Wayne State University School of Medicine, Department of Family Medicin
e, designed and delivered a comprehensive curriculum as part of the practic
e's faculty development initiative surrounding the coding challenge. The au
thors defined outcomes expected on the way to achieving 100% compliance wit
h HCFA's guidelines. Their curriculum covered topics of coding theory, char
t auditing for coding, team building, effective meetings, and structured pr
oblem solving. The curriculum was delivered from January to May 1998. Chart
audits of 251 charts.(office notes) from before the intervention and 263 c
harts from after the intervention were performed to evaluate differences in
coding accuracy. Errors were significantly reduced. The total error rate d
ropped from 50.2% to 31.1% (p <.05). Overcoding errors were reduced by one
third (29.1% versus 19.7%), while undercoding errors were reduced by half (
16.3% versus 8.4%). Other errors fell from 4.7% to 3%. The approach of defi
ning and developing work teams and then using standard quality improvement
tools may be an effective way to improve compliance with HCFA billing and c
oding rules. In addition, faculty development can be incorporated into the
process of solving a problem that faces a faculty.