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What Are the Most Popular Ways to Improve Coding Errors?

Medical insurance coding accuracy is vital to the medical billing process. "Clean claims," meaning those without errors, must be submitted to the insurance company to avoid a disruption in the flow of reimbursement payments. If the flow of reimbursement payments is disrupted to a medical facility, the facility will have less money to pay facility, supply and staffing costs. Common medical errors stem from a variety of reasons, including misreading or not reading carefully, not coding to the highest level of specificity and coders' inexperience. These common coding errors can be avoided by taking steps to improve coding accuracy.

  1. Request an Audit

    • A coder can request to have an audit performed of the cases he has coded. Auditing services are a standard way to improve coding accuracy. An audit will go over cases that have been submitted for payment and calculate the coder's accuracy with these particular cases. An audit can be requested by visiting the website of the U.S. Department of Health and Human Services Office of the Inspector General (OIG) (see Resource section).

    Take a Coding Class

    • Enroll in an accredited coding course offered by a professional coding organization such as the American Association of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). Both of these organizations offer information regarding coding classes and certification tests in your area. These classes are beneficial, especially if you are new to coding. Many aspects of the coding books are explained in these coding classes, and many sample cases and scenarios are given to students to help them understand the different guidelines for ICD-9, CPT and HCPCS coding.

    Specialize

    • Coding can be difficult, especially if you are trying to code a cardiology or neurology procedure that you are not familiar with. Specializing in a specific area of medicine can make a coder more familiar with the types of procedures billed in that particular area, thereby reducing errors. Coders who specialize are more familiar with the codes in their specialty because they are exposed to more experience with these types of cases.

    Read Carefully

    • The ICD-9, CPT and HCPCS code books are extremely detailed. Special notes are sometimes included under codes or section headings that may sometimes be missed if the coder does not read carefully. Some codes will contain exclusion notes listing conditions or procedures that should not be billed a certain way or in addition to another code. Read all coding guidelines and notes very carefully to avoid errors.

    Medical Coding Software

    • Many medical practices are already using specialized medical software to aid with patient records and scheduling. Some of these medical software programs also include aspects that help with accurate billing and coding. For example, if a procedure is coded that does not match the diagnosis code, the program would send the coder an error message and not let the codes be entered together. If several codes are billed at the same time, the medical coding software will assign certain codes automatically according to keywords. When medical coding software is used, coding errors are virtually eliminated since the software program will not let any codes or code sequences be billed if they do not meet the insurance company's reimbursement guidelines.

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