The financial health of medical practice depends on the strategies deployed to reduce expenses while increasing revenue. To keep up with escalating company expenditures, it is essential to ensure that all sources of income of leaks are blocked and eliminated. Physicians are reimbursed for their services based on the diagnostic and procedural codes they provide in their claims.
Incorrect medical coding is a major worry for practitioners, which may lead to claims being rejected. Furthermore, a lack of follow-up leads to an increase in the amount of money owed. Payers fail to pay a significant portion of AR.
Coding mistakes may cost businesses thousands of dollars, and if they are made regularly, they can harm compliance.
What are some common Coding Mistakes?
1. Not coding to the greatest degree of detail: When coders aren’t familiar with the medical language or don’t take precise notes, the coding isn’t done to the highest level of precision.
2. Inadequate documentation: It is difficult to give the right codes when the paperwork supplied to the billing/coding personnel is inadequate. Under coding may also be caused by misreading a provider’s handwriting.
3. Unbundling: A set of related operations may have a single code. Unbundling refers to the use of distinct codes for these operations. This coding mistake is against the law.
4. Upcoding: It is the use of a code for a more costly process than the one that was performed. It also includes tests performed by technicians that are classified as if they were performed by doctors.
5. Undercoding: When all of the treatments and services provided are not recorded and invoiced, this is known as under coding.
6. Correct use of Modifier: Appending unsuitable modifiers, overusing modifier 22, inaccurate reporting of infusion and hydration codes and injection codes, and reporting unlisted codes without sufficient documentation are all examples of wrong modifier use.
7. Failure to utilize current codes: All code sets are updated and revised regularly. Coders must be updated on these modifications regularly.
Claim Rejection can be avoided with the best practices mentioned below:
- CPT and HCPCS code sets are constantly revised, therefore educating coders is essential. Coders need to be aware of any changes in rules and laws.
- To ensure correctness, programmers must examine their work post-completion.
- Coding mistakes may be eliminated by having an internal audit team that verifies the accuracy of the code.
- The importance of regular training cannot be overstated. If you want coders to avoid overcoding and undercoding, and bring a maximum degree of detail, you must train them often. To avoid complacency at any moment, it is critical to maintaining vigilance.
Error-free coding is not an easy task! It takes a lot of effort and resources. Coding and reimbursements both go hand-in-hand. Therefore, outsourcing medical coding service to an experienced revenue cycle management provider is a wise decision. Tall RCM extends professional medical coding services. We can assist you with every step of the revenue cycle, not just the coding. Our billing team will work with you to develop a solution that meets your specific needs. You may finally put an end to your back-office woes.