Medical Coding Errors and Omissions

Medical Coding Errors and Omissions

Accurate medical coding is important for many reasons. Having correct medical coding will ensure appropriate reimbursement for medical services provided. There are many times of billing errors that can occur. Here are some examples of common medical billing errors and coding errors.

Types of Medical Coding Errors

  • Upcoding can occur when medical billing code is incorrectly used to reflect a more severe treatment or diagnosis. Examples of upcoding include coding for a name brand medication when a generic medication is given to the patient or a regular office visit is coded as an inpatient care.
  • Unbundling is when charges that would usually be grouped together under the same code are listed separately.
  • Duplicate billing is when a patient is billed for the same service more than once.
  • Balance billing errors can occur when a patient has a leftover balance after the claim is submitted to the insurance company by a doctor’s office or hospital.
  • Lack of medical necessity is when a doctor does not provide a medical coder with correct information about a patient’s diagnosis, the wrong code may be used on the bill, and an insurance company may deny the coverage citing “lack of medical necessity.”
  • Incorrect patient information can occur if a patient’s name is misspelled or an insurance number is incorrect. Incorrect patient information can cause the claims to be rejected by the insurance company.
  • Mismatched treatment and diagnosis code errors can occur with a medical biller codes a patient’s diagnosis but does not change the treatment code to match. An insurance company will typically reject the claim due to this error.

All of these errors and omissions will cause issues with billing and reimbursement. It is important to have experience medical coders to ensure that these errors can be avoided. Reducing and eliminating these errors can help increase reimbursements. With the right medical coders on your team and the right training, these common errors can be prevented.

HCC Coders can help!

HCC Coders can help you with all of your HCC coding needs. Our team of HCC coders are experienced and highly qualified to avoid the common coding errors above. Our HCC coders are experts at coding and know the type of common errors to look out for. Trust that our team can accurately fulfill all your HCC coding needs. Give us a call at 877-328-2343 to see how are HCC team can help you reduce your coding errors and complete your coding needs.