Question

Discuss some common causes of coding errors and the preventive measures you can use to avoid them. What are some other measures you can add to the list that might not be in the course materials?

Answer 1

Medical coding is the transformation of health care diagnosis,procedures, diagnosis,procedures, equipment, medical services into Universal medical alphanumeric codes. Any mistake in these process results in coding errors.

Common causes of coding errors includes

• Submission of incomplete data. Failure to provide complete data to support claims results in denials.
• Upcoding

Upcoding occurs when codes are entered into a patient's bill for services that were not received.

• Undercoding

Undercoding occurs when codes are left out of a patient's bill.

• Telemedicine coding errors. Incorrect use of modifiers for telehealth services results in payment delays.
• Incorrect procedure codes
• Unbundling codes or using multiple codes for parts of a procedure.
• Failure in checking National correct coding initiative edits when reporting multiple codes.
• Improper reporting of time based on infusion and hydration codes
• Errors in reporting injection codes
• Reporting of unlisted codes without documentation.
• Selecting wrong procedure code. Incomplete or inaccurate code descriptions on cheat sheets and electronic charge systems are a significant source of error.
• Failure to keep upto date knowledge on new coding rules and initiatives is an expensive mistake.

Preventive measures to avoid coding errors

• A large number of errors can be prevented if a provider can verify the benefits the patient can avail.
• Always double check for any mismatch in patient's information. Any errors in patient's name, gender and birthday can cause claims rejection.
• Double check the correct procedure code to successfully reimburse the healthcare claims.
• Maintain accurate automated billing system.
• Carrying out chart audits can help prevent double billing.
• Coding must be highly specific and accurate to avoid rejection of health care claims.
• Stay updated on coding rules. Out dated reference manual can affect the reimbursement process.
• Using advanced medical billing softwares helps to reduce billing and coding errors.
• Verify the insurance coverage to assess patient's eligibility everytime they render services.
• Implement a practice management system as much as possible to reduce human errors.
• Always double check the claims before submission.
• Be careful of inadvertent upcoding or undercoding.
• File the medical claims within designated deadlines.