Article Reference Code: NAMAS.09.26.2025
Coders vs. Auditors: A Lighthearted Look at Life on Both Sides
Written by: Dawson Ballard
As someone who’s been on both sides of the fence—as a coder and now an auditor—I’ve come to appreciate the unique role each plays in the world of reimbursement. Both have their perks (and their pitfalls), so here’s a lighthearted take on the ever-entertaining tug-of-war between coding and auditing.
Let’s face it—coders are the unsung artists of healthcare. We take a provider’s cryptic shorthand—“Pt c/o abd pain, r/o appy, labs WNL, d/c’d”—and somehow turn that into a symphony of CPT®, ICD-10, and HCPCS codes. It’s not just data entry. It’s decoding under pressure, and occasionally, telepathy.
My view of coding:
· Favorite phrase: “It’s not unbundling, it’s optimizing.”
· Spirit animal: A raccoon—always digging through garbage (aka documentation) for treasure.
· Biggest challenge: Deciphering handwriting that looks like it was written during a rollercoaster ride.
Now, as an auditor, I’ve switched sides—but not really. Auditors are the guardians of compliance, the defenders of documentation, and yes—the reason some coders sleep with one eye open. We swoop in with our magnifying glasses and spreadsheets, asking the dreaded but necessary questions—like, “Can you explain why you used modifier 59 here?”
My view of auditing:
· Favorite phrase: “Let’s pull the chart.”
· Spirit animal: An owl—wise, watchful, and slightly terrifying.
· Biggest challenge: Staying calm when I find a level 5 E/M billed for a paper cut.
How it sometimes goes down in my world:
Coder: “I used 99214 because the provider spent 30 minutes with the patient.”
Auditor: “Right, but 25 of those minutes were spent talking about golf.”
Coder: “I added modifier 59 to bypass the edit.”
Auditor: “You bypassed compliance too.”
Coder: “I coded it based on the documentation.”
Auditor: “You mean the part where it says, ‘see previous note’?”
But here’s the truth: despite our differences, coders and auditors are two sides of the same claim. Coders build the bill; auditors make sure it doesn’t implode during a payer review. Together, we keep the revenue cycle spinning—and the compliance gods appeased.
So the next time your auditor flags your beautifully coded claim, remember—we’re not trying to ruin your day. We’re trying to make sure it doesn’t end with a Medicare audit and a 47-page rebuttal. Show your auditor a little love. We’re only here to help.
Dawson Ballard Jr, RHIA, CCS-P, CPC, CPMA, AAPC Fellow
Dawson Ballard, Jr. has an unquenchable passion for medical coding, so much so that many affectionately call him a true “coding nerd.” With more than 20 years of experience in CPT, ICD-10-CM, and HCPCS coding, he has built his career as a respected consultant, auditor, and educator. His consulting work focuses on Evaluation and Management (E/M), risk adjustment, and ICD-10-CM coding, with expertise spanning multiple specialties, including OB/GYN, Family Practice, and Internal Medicine.
Actively engaged in the medical coding community, Dawson is a proud member of both AAPC and AHIMA. His involvement includes publishing professional articles, serving as a local AAPC chapter officer, and contributing as a board member for his AHIMA State Component Association. He has also delivered numerous educational presentations for local chapters and his state association, sharing his knowledge and advancing the profession.
In recognition of his contributions and years of service, Dawson has been honored as a Fellow of AAPC, a distinction that reflects both his expertise and his enduring commitment to the medical coding profession.
