What Are the Liabilities of Medical Coding?

Coding is the medical business practice of matching the clinical documentation in a patient’s record to numerical and alphanumerical codes for reimbursement of services. Medical coders deal with confidential patient information and can be liable for a breach of that information.

Understanding Liabilities

• Medical coders are liable, or legally responsible, for the confidential patient information with which they work. Although medical coders do not work directly with patient care, they do provide services that affect patient information.

Incorrect Code Assignment

• Coders are responsible for all codes submitted for billing, even if they are incorrect. In most cases, incorrect code assignment results in denied claims. However, circumstances exist for coders to be charged with fraud.

Incorrect Reimbursement

• In some cases, incorrect code assignments can result in increased reimbursement. Submitting false billing claims can be viewed as a criminal activity and punished by law.

Privacy

• A patient's health information is private and is protected against being shared in an unauthorized manner. A medical coder who shares or inadvertently releases patient information can incur civil penalties of $100 or more for each occurrence or criminal penalties, including jail time.

Security

• It is the coder’s responsibility to secure electronic patient information from the patients with which they work. The increased use of laptops containing patient medical information and the potential for theft create liability issues.