5 ways medical coding is a burden on clinicians

The hidden costs of clinician-led coding

Medical coding plays a critical role in practice operations and revenue cycle performance. When coding is inaccurate, incomplete, or delayed, the effects can ripple across the practice, contributing to claim denials, rework, delayed reimbursement, and compliance concerns.

Coding work is also increasingly complex. Medical coding teams have to keep up with frequent rule changes, payer requirements, and detailed documentation expectations. The Current Procedural Terminology (CPT) code set includes more than 11,000 active codes, and the 2026 CPT update made 418 changes, including 288 new codes, 46 revised codes, and 84 deleted codes. As coding requirements evolve, practices need workflows, training, and support that can keep pace.

For clinicians, that complexity lands on top of an already demanding day of providing and documenting patient care. Clinicians play an essential role in accurate documentation, but when they are also expected to own coding-heavy administrative work without clear workflows or support, the hidden costs often register in staff efficiency, claim performance, patient experience, and overall practice operations.

That's why reducing coding burden starts with clear ownership. Practices need to define who owns documentation, who reviews and validates codes, who handles payer-specific checks, and who is accountable for follow-up when denials occur. It's leadership's responsibility to reinforce that process with the right training, support, and technology. Without that structure, coding can become a recurring source of strain for clinicians and billing staff.

The 5 burdens coding places on practices

All practices face constant pressure to maximize efficiency and revenue while maintaining quality care. With that pressure as a permanent backdrop, what are the specific burdens that clinician-led medical coding places on clinicians and practices?

1. Staff inefficiencies around the coding process

When coding workflows are not clearly defined or understood, inefficiencies can build quickly. Clinicians and staff may spend more time clarifying documentation, correcting errors, or determining who owns the next step. The result is more work, slower claims submission, and less predictable revenue performance.

Clear ownership establishes a single point of responsibility for rectifying errors and managing claim denials. It also enables leadership to drive claims turnaround time and overall process improvement.

2. Financial impact of coding errors and missed revenue

When they occur, errors can lead to denials, which have a significant impact, leading to meaningful financial and operational strain for a practice. In a 2024 Premier survey of hospitals, health systems, and post-acute care providers, nearly 15% of medical claims submitted to private payers were initially denied.¹

Denials also create rework. The American Health Information Management Association (AHIMA) reports that the cost to rework or appeal a denial average $25 per claim for practices and $181 per claim for hospitals.²

Some of the top medical coding errors identified by the American Medical Association include unbundling, up- or downcoding, incorrect modifiers, and failure to reference National Correct Coding Initiative (NCCI) edits for multiple code reporting.

3. Frequent coding updates and audit risk

Medical coding is constantly evolving and errors can stem from many sources, including changing requirements, unclear workflows, incomplete documentation, fatigue, oversight, or gaps in coding expertise.

Training gaps can also contribute to burden, especially for clinicians early in their careers. One study of nearly 2,000 recent pediatric graduates in the U.S. found that 81% of generalists and 78% of subspecialists³ said they could have used additional training in billing and coding.

4. The opportunity cost of clinician coding time vs. patient care

Good care for patients and transparent, predictable billing practices are what drive both patient satisfaction and practice performance. In a daily practice environment of limited time and competing priorities, clinicians should spend as much time as possible on work that requires their clinical expertise, rather than spending time on medical coding tasks.

5. Connection between administrative burden and clinician burnout

Administrative work is one of the factors that contributes to clinician stress and can ultimately lead to burnout. This is especially true when it adds time pressure outside of direct patient care. Among the “Big 4” factors driving physician burnout, according to the American Medical Association, is “time pressure” created by medical record documentation and coding requirements.

These burdens do not mean clinicians should be removed from the coding process. Instead, practices need a clearer model for who owns clinical documentation, who owns coding review, and how technology and workflows are evolving to support both.

3 Best practices for reducing clinician coding burden

When clinicians are expected to manage too much of the coding process manually, delays, rework, and inconsistency can follow. Here are some ways practices can address that:

1. Separate clinical inputs from coding-heavy administrative work.

The goal should not be to remove clinicians entirely from the coding process. Instead, it should be to ensure that clinicians own the clinical inputs (including diagnosis, treatment, accurate documentation), while trained coding specialists, billing teams, or designated trained staff own the coding-heavy review, validation, and follow-up work where possible. By keeping the responsibilities separate and clearly defined, practices can improve operational efficiency and accuracy.

2. Create and align with standardized documentation and coding workflows.

Inconsistent processes are one of the biggest reasons coding can become burdensome. If documentation expectations vary and handoffs are informal, medical coding becomes slower, more error-prone, and stressful. That combination can become a common source of operational and financial strain, while increasing the likelihood of coding errors, denied claims, and audit or compliance concerns.

The solution for practices is in creating standardized, aligned documentation and coding processes so everyone involved knows exactly what to do, as well as who’s accountable for what and when.

3. Review coding performance, denial trends, and staff responsibilities.

Practice leaders should pair clear coding workflows with ongoing performance management, supported by the right tools, reporting, and review processes. With that visibility in place, practice leaders can assess whether their current coding model is meeting expectations and identify opportunities for improvement.

Every practice will divide responsibilities differently, depending on staffing, specialty, payer mix, and technology. But a clear ownership model might look like this (task on left, owner on right):

• Clinical documentation: clinician
• Diagnosis, encounter details, treatment plan: clinician
• Code selection, review, or validation: trained coder, billing team, or designated trained staff
• Payer-specific coding checks: coding or billing staff
• Denial trend review: practice manager or billing lead
• Workflow accountability: practice leadership

Practice leaders should not assume that coding responsibilities are distributed effectively just because the practice is functioning day to day. Instead, they need the capacity to bring oversight to the coding process and drive both quality assurance and continuous performance improvement.

Conclusion: Supporting efficient coding workflows

Reducing clinician coding burden starts with a clearer operating model. Practices that define ownership, standardize documentation and coding workflows, and monitor performance over time can reduce rework, support more accurate claims, and help clinicians spend more time on patient care.

Explore how athenaOne®'s Practice Management solution can support more efficient revenue cycle workflows and help practices reduce administrative burden for clinicians and staff.