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Day 1 of the Becker's Hospital Review 12th Annual Meeting

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Prevent Errors in Medical Coding Services

Medical coding is a process of applying universal alphanumeric codes to the healthcare services like medical diagnosis, procedures, and services and medical equipment used for a patient. A patient’s medical records and documents like doctor’s notes, lab reports, and services lists are used by the medical coders to ascribe the diagnosis and procedure codes.  

Medical coders abstract the medical information from the available documentation, assign the right diagnosis and procedure codes and enable the process of friction-free claims submission. Coding must be accurate, efficient, and secure to maintain healthy revenue and compliance for the healthcare providers. 

 

Coding Errors Affect Revenue Cycle Management (RCM) 

The coders must identify the diagnosis and treatments received, and code them properly with ICD-10 code. These codes show how much an entity is reimbursed for a specific treatment. Then the coders must select the most accurate code for all the treatment specifications to prevent the claims denials.  

 

The medical coding error costs huge and ends up in claims denials. It creates unwarranted compliance issues, which are also more expensive. 

 

Major coding errors: 

1.      Missing Details 

The most common coding denial happens when the wrong code was selected based on new or established patient guidelines. This denial is an alarm to check the entire chart and not just the header. Another reason for denial would be when a procedure is coded as ‘routine’ rather than as ‘diagnostic’. In these cases, missing the details of medical records are the results. 

  

2.      Using Shortcuts 

Though shortcuts seem helpful and get you fast, they would take you to the dead end. Fixing the errors once done is costly and more time-consuming than having it done correctly in the first place. When a coder enters the codes for the charges without reviewing the provider’s documentation/reports, there is a high probability for the codes to go wrong or be missed.  

 

 

3.      Being Comfortable with Codes 

Though being comfortable with codes, and not having the necessity to check the codes seem expertise and experience in medical coding, auto-pilot mode is another reason for coding errors. They should read the reports and code to the highest level of accuracy than simply relying on their memory. 

 

Prevent the Errors: 

1.      Check Mismatch of Patient’s Information 

Insignificant errors like errors in patients’ names and gender can be a reason for claims rejection. The coders should check the patients’ information thoroughly. 

 

2.      Double-checking Information 

The coders should use the latest coding books for reference to avoid errors. And always, double-check the information coded that can cause claims denial. Correct procedure codes and diagnoses are mandatory to reimburse the claims. 

  

3.      Highly Specific Codes 

The coders are responsible for the specificity of the codes, as ICD-10 codes required the last two digits to be highly accurate to prevent claims denial. The coders should refer to the codebook often when they are not sure about the codes for a specific diagnosis. 

  

4.      Using Latest Coding Manual Reference 

Outdated reference affects the claims process. The coders must update themselves with the latest coding manuals and be relevant to the current coding standards. Using the latest coding manuals as a reference saves time, energy, and friction. 

 

Preventing errors in medical coding is inevitable in the first place. Coding audits are also helpful yet being accurate while coding can save a lot of time and money for the healthcare providers. When selecting the medical coding services and medical coding companies, the providers should be careful enough to check whether the service company can make the services better for you. As said earlier, errors in coding affect RCM. 

 

Becker's Hospital Review - 12th Annual Meeting

Join Vee Technologies at the Becker’s Hospital Review 12th Annual Meeting, and let our revenue cycle management, health IT, and clinical experts show you how we deliver extraordinary outcomes to some of the largest healthcare organizations in the country. Stop by booth 203 and register to win our exciting giveaway!

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Provider Credentialing & Enrollment

Provider enrollment services is a process of getting a physician affiliated with the payer, which is a critical stage in RCM. Vee Technologies’ provider Credentialing & Enrollment services ensure all the documents are received, processed, and approved for the provider to begin seeing patients.

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