Common Medical Coding Errors and How to Prevent Them?

Medical coding accuracy is crucial to receiving payment for medical billing. Coding tallies take up a significant amount of time during the claims processing procedure. Claims are quickly cleared if the coding matches the diagnosis or procedure. Common Medical coding Errors cause delays when they are present. Additionally, blatant errors result in denials. The main coding mistakes that can prevent you from receiving a clean reimbursement are examined in this blog.

Learn about the following medical errors: 

Errors in Documentation

Errors in documentation can occur for a variety of reasons. These include mistakes with prescriptions, transcribing, administrative documentation, etc.

An appropriate procedure may be put in place to control many of these problems. The most important one of them is giving clinicians and internal administrative employees the most recent training in healthcare services. 

Changing medical laws, drugs, unidentified allergies, contraindications, having a proper cross-checking mechanism in place, including protocols for prescription orders, abbreviations, drug lists, asking pharmacists questions, etc., must all be included in the training.

Using software and other technologies is an easy approach to checking for problems. These solutions can help you reduce errors to almost zero by identifying mistakes and missing fields on their own.

Causes: How to fix medical coding errors? 

• Improper application of prescription medicine orders.
• Typographical errors when taking notes.
• After inputting the first few letters, choosing the incorrect medication.
• Inadvertently entering the incorrect drug dosage, such as daily or weekly.
• Handwriting that is difficult to read and incorrect abbreviations.

Unbundling

A form of medical billing fraud is “unbundling.” Even when done unintentionally, it can sometimes be perceived as a conscious attempt to deceive. Instead of using the one available code, several procedures are billed separately. A billing split is regarded as a fraud because it enables the practitioner to recover more money for the same treatment. It is also one of the most common medical coding errors.

Here’s a nice illustration of unbundling: instead of using the usual billing code for a routine surgical procedure, enter separate codes for the incision and suturing. This facilitates the practice’s ability to demand additional payment from the payer.

Unbundling might result in severe punishments. Because it can occasionally be committed unintentionally, practices can make sure that this doesn’t happen by providing personnel with proper training and having a reliable quality control system in place.

Upcoding

Another sort of fraudulent medical billing is upcoding. In this kind of billing, practices frequently submit claims that are more expensive than they should be. This mainly occurs when more expensive codes are assigned than what was done. The charging of sedation as sophisticated anesthesia, the billing of a simple X-ray as a complex one, and the billing of a nurse-performed procedure as a doctor-performed procedure are a few examples of these. One of the most popular coding errors in healthcare. 

Upcoding is considered a fraud and an attempt to game the system. Healthcare professionals must abstain from doing this as a rule. The effects of this malpractice must be made clear to the workforce.

Under coding

The reverse of upcoding is under coding. It also goes by the name “down coding.” Certain documentation details are purposefully left out of this style of coding. The process does not provide the appropriate level of specificity for the procedure. Some businesses do this on purpose to reduce the possibility of claims being denied. This can occasionally aid in preventing issues from coming up during audits. According to legal criteria, under-coding is against the fundamentals of medical coding. Additionally, it is seen as an attempt to hack the system. Improving the process of assuring accuracy in diagnosis matching was one of the motivations for switching to ICD-10. Diabetes is one condition that frequently remains undiagnosed.

Duplicate Billing

By sending the same bill to two distinct payers, a duplicate bill is an attempt to receive payment twice. It can be similar to billing the patient, Cyber help health solutions provider for the same operation. This can also occur if two different doctors give the same patient the same bill for a procedure done on the same day and by two different providers. Duplicate billing is defined as any attempt to charge more than once for the same service. Duplicate billing, for instance, is when a code is billed separately from a bundle of tests.

Medical billing and coding errors can prove to be quite expensive for providers in the short term as well as the long term. What are common errors in medical coding? This question must be resolved by reading the above-mentioned points. Therefore, healthcare practices must make every effort to ensure that medical coding is 100 percent accurate. One simple method is to hire a third-party medical coding company or one of the many US outsourcing organizations for medical coding.

Cyber help health solutions brought this article to your attention. We have more than 20 years of experience as a professional provider of medical coding services. Contact us right away if you’re searching for the greatest coding solutions.