{"id":3462,"date":"2018-10-11T15:11:24","date_gmt":"2018-10-11T15:11:24","guid":{"rendered":"http:\/\/medisysdata.com\/?p=3462"},"modified":"2023-10-14T15:28:50","modified_gmt":"2023-10-14T09:58:50","slug":"prevent-top-medical-coding-mistakes-in-2018","status":"publish","type":"post","link":"https:\/\/www.medisysdata.com\/blog\/prevent-top-medical-coding-mistakes-in-2018\/","title":{"rendered":"Prevent Top Medical Coding Mistakes in 2018"},"content":{"rendered":"

[vc_section][vc_row][vc_column][vc_column_text]Medical coders and billers are critical to the healthcare business. By carefully recording patient treatments and procedures they keep doctors and nurses organized and on track. Also they submit bills to insurance agencies, which then pay claims. If biller or coder makes a mistake, it can delay the claims process, cause a loss of revenue and\/or potentially affect a patient\u2019s care.<\/p>\n

Recent audits by Government and private insurers\u2019 have exposed many unfortunate cases of abusive or fraudulent medical billing practices. While you deserve to be paid for the medical care you provide, but it is equally important that you avoid improper billing practices to stay away from trouble and continue a booming practice.<\/p>\n

Medical Coding errors fall into two wide categories \u2013 \u201cFraud\u201d & \u201cAbuse\u201d. Fraud is deliberate misrepresentation. Whereas abuse means \u201cthe falsification was an innocent mistake, but nonetheless representative,\u201d according to the AMA\u2019s Principles of CPT\u00ae Coding<\/em><\/a>, ninth edition. Either way, the consequences are costly. An example of abuse could include coding for a more complex service than was performed due to a misinterpretation of the coding system.<\/p>\n

Here are some of the most common mistakes to avoid in medical coding that can result in claim denials, costing your practice big time.<\/p>\n

Unbundling codes<\/strong>
\nWith huge number of CPT codes, it is extremely easy to unintentionally select the incorrect procedure code when completing claims. Unbundling means using multiple CPT codes for different constituents of a procedure when a single code can be used instead to capture all the constituents. It involves charging procedures individually so that the provider gets a greater payout. It is considered intentional and fraudulent. Single catch-all codes should be used when available.<\/p>\n

Upcoding <\/strong>
\nUpcoding happens when a provider meets with a patient for a few minutes, however a coder bills for a full exam lasting 45 minutes. The consequences for upcoding can be severe. In one instance an psychiatrist was fined $400,000 for upcoding. He used to charge for 30 or 60 minutes sessions with patients even if in reality he was only meeting them for 10-15 minutes for checking medications.<\/p>\n

Neglecting<\/strong> to check National Correct Coding Initiative (NCCI) edits when reporting multiple codes. <\/strong>
\nThe Centers for Medicare & Medicaid Services developed the NCCI to make sure that accurate coding methods were followed and avoid inappropriate payments for Medicare Part B claims. The NCCI analyzes every pair of codes to see if an edit exists. If there is an NCCI edit, it means a code is denied.<\/p>\n

Neglecting to add the suitable modifiers, or appending wrong modifiers <\/strong>
\nCare should be taken to add correct and suitable modifiers.<\/p>\n

Overusing modifier 22\u2013increased procedural services<\/strong>
\nIt is very important to \u00a0include appropriate documentation explaining why the procedure requires more work than usual.<\/p>\n

Reporting unlisted codes without documentation<\/strong>
\nIf proper billing necessitates the use of an unlisted code, it’s imperative that the unlisted code is adequately documented<\/p>\n

Reporting Injection Codes Inaccurately<\/strong>
\nCoders should only report one code for a entire session including injections. Do not report several units of a code.<\/p>\n

Outsourcing your medical coding services<\/a> to a medical coding company \u00a0can help your practice avoid these top coding errors. It enhances\u00a0 your reimbursement and reduces your practice compliance risk[\/vc_column_text][\/vc_column][\/vc_row][\/vc_section]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

[vc_section][vc_row][vc_column][vc_column_text]Medical coders and billers are critical to the healthcare business. By carefully recording patient treatments and procedures they keep doctors and nurses organized and on track. Also they submit bills to insurance agencies, which then pay claims. If biller or coder makes a mistake, it can delay the claims process, cause a loss of revenue […]<\/p>\n","protected":false},"author":1,"featured_media":4939,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","footnotes":""},"categories":[3],"tags":[],"class_list":["post-3462","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services"],"yoast_head":"\nPrevent Top Medical Coding Mistakes in 2018<\/title>\n<meta name=\"description\" content=\"Prevent costly errors and enhance accuracy by learning how to avoid top medical coding mistakes in 2018. Protect your revenue.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medisysdata.com\/blog\/prevent-top-medical-coding-mistakes-in-2018\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Prevent Top Medical Coding Mistakes in 2018\" \/>\n<meta property=\"og:description\" content=\"Prevent costly errors and enhance accuracy by learning how to avoid top medical coding mistakes in 2018. Protect your revenue.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.medisysdata.com\/blog\/prevent-top-medical-coding-mistakes-in-2018\/\" \/>\n<meta property=\"og:site_name\" content=\"Leading Medical Billing Outsourcing Services Company in the USA\" \/>\n<meta property=\"article:published_time\" content=\"2018-10-11T15:11:24+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-10-14T09:58:50+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2018\/10\/Blog_Prevent-Top-Medical-Coding-Mistakes-in-2018-1024x384-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"384\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"medisys\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"medisys\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Prevent Top Medical Coding Mistakes in 2018","description":"Prevent costly errors and enhance accuracy by learning how to avoid top medical coding mistakes in 2018. 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