5 Common Medical Coding Mistakes and Prevention Strategies

Everybody knows how crucial the role of medical billers and coders is for any healthcare facility. The proper flow of healthcare operations is only possible with error-free medical coding and billing. But, errors cannot be avoided as they are natural and a part of any organization. Medical billing and coding are significantly used by hospitals, clinics, and other healthcare facilities. However, medical billing and coding errors can result in negative consequences. Errors may be intentional or unintentional, resulting in claims rejection, the reverse process, or even legal issues. Here are some of the common coding errors and how to fix them to provide unique and compliant medical billing services:

• Incorrect interpretation of operative reports

Coders have instructions not to bill for the procedure until it is specifically documented by the doctor.  Coders will not code the description of the procedure that is listed in performed. They will need an actual operative description. This issue can be addressed in two ways: the provider can ensure to mention the specific operative description required, and second, a skilled coder should be able to understand an operative report properly and provide accurate coding.

• The coder is unaware of bilateral procedures or services

The medical coder is not present at the location. They are away from medical facilities and patients. If the doctor leaves to write bilateral procedures or services like injections, medicines, diagnosis,  X-rays, and others, the biller will not be able to code for them.  The provider must realize that a coder is a very important part of the coding process and the bilaterals must be highlighted in the report to not interrupt proper medical billing services.

• Unbundling

This means breaking procedures into pieces and charging for each thing separately when there is already a comprehensive code.  Unbundling is illegal and unethical.  It will lead to an audit.  Make sure your coders are aware of comprehensive codes. 

• Coding not as per the highest specificity

Some ICD-9-CM codes need some digits to get to their highest specificity.  If it is incomplete, the claim will get rejected.  If a coder is not sure of a diagnosis is coded to its highest level of specificity they can look it up in the codebook or on the internet.

• Incorrect codes are used for outdated reference

You should send coders to webinars and seminars related to medical coding and billing. This way they can learn new coding techniques and recent developments in the healthcare world. Also, learning new practices and getting aware of new guidelines will minimize errors and generate more revenue.