Coding expert aims to help fellow family physicians get paid properly

“He began by telling us we were pretty ignorant,” Weida said, “and we were about all ready to jump over the desk and throttle him. But by the end of the talk, we were all sick to our stomachs because of all the money we were leaving on the table.”

The expert, who was invited back to the conference the following year, proposed that physician billing should be based on medical decision-making and the complexity of the patient. The history and physical were secondary.

“That was really a different approach because looking at it that way was backward compared to how we were being taught,” said Weida, who was in private practice for more than a decade before becoming an associate professor of family medicine at Hershey Medical College in 1997. “That’s what started my interest in coding and billing, trying to get people involved and doing the right thing for coding. I find almost all docs are leaving money on the table due to improper coding.”

More than two decades later, CMS bought in to what Weida and others were advocating for, simplifying coding for office and outpatient visits in 2021 by allowing clinicians to choose code levels based on medical decision-making or total time spent with a patient.

Weida no longer needs a grant to get an expert opinion on coding. He is the expert.

A founding member of the FPM Editorial Board, Weida served in that role for a decade and has held a similar role with the AMA’s CPT Assistant since 2016. Since 2009, he has served in a variety of roles as an AAFP representative or delegate to the AMA Relative Value Update Committee, a multispecialty group of volunteers who make recommendations regarding physician payment to CMS.

“I’ve stuck with it because it takes a long time to understand the nuances of the RUC,” said Weida, who since 2015 has been a professor in the Department of Family Medicine at the University of Alabama College of Community Health Sciences and in the Department of Medical Education at the University of Alabama at Birmingham Heersink School of Medicine. “Even now I continue to learn. I feel it’s important that family medicine have a voice there. We have been able to do some good things, including the new evaluation and management coding guidelines that family medicine, geriatrics and other primary care specialties were able to influence. That made a big difference.”

Weida will share his expertise with his peers during the Family Medicine Experience, which is coming to Anaheim, California, Oct. 5-9. Weida and his wife, Jane Weida, MD, FAAFP, a professor in the Department of Family, Internal and Rural Medicine at the College of Community Health Sciences at the University of Alabama, will lead a lecture and two related problem-based learning sessions on evaluation and management outpatient codes.

“There have been some new changes with the complex chronic care code G2211 that are favorable for family medicine,” said Weida, who also is an associate dean for clinical affairs at the University of Alabama College of Community Health Sciences and chief medical officer of University Medical Group, Tuscaloosa. “I’ll talk about some other additional codes that we don’t use as much but could be valuable for a number of folks. We’ll be reemphasizing how to do proper evaluation management coding.”

At the end of his presentations, Weida asks attendees how many times they are undercoding each day. The typical answer is three. Weida said that likely translates to more than $30,000 a year in lost income.

After last year’s talk at FMX, attendees asked for more examples of how to address difficult coding issues. Weida said adding the problem-based learning sessions will allow him to do that.

“Those will be a lot of fun because we’ll cover a lot of different scenarios,” he said.

In addition to coding, count Weida an expert on parliamentary procedure. He currently is speaker of his state medical association, a position he also held in the Pennsylvania AFP and the AAFP. He also has represented the AAFP, the Pennsylvania Medical Society and the Medical Association of the State of Alabama in the AMA House of Delegates.

“I enjoy helping get people where they want to go, representing the will of the majority but also allowing the minority to have a say and an influence,” said Weida, who was the AAFP vice speaker and speaker from 2002-04 and speaker from 2004-08. “I enjoy it. It’s a whole different skillset.”