4 of the Most Common Medical Coding Mistakes
Mistakes are a part of life. As Albert Einstein once said, “a person who never made a mistake never tried anything new.”
If you’re new to medical coding, chances are pretty good that you’re going to make a mistake or two. (OK, it’s guaranteed.) But when that happens, you have two options:
You can get down about it.
You can learn from it and become a better coder
Today’s blog post is all about the latter. We’re going to cover four of the most common medical coding mistakes and then tell you what you can do about them.
Mistake #1: Not Coding to the Highest Level of Specificity
This is a big reason why insurance carriers deny claims. Basically, your codes aren’t specific enough. In the eyes of the payer/insurance carrier, if a procedure or service line is not documented, you can’t code it. So make sure the diagnosis is documented and coded to the highest level of specificity for that code (i.e. maximum number of digits). For example, if you’re coding a fracture, include the type of fracture. You get the idea.
Mistake #2: Bad or Missing Documentation
Building on the last mistake, documentation is crucial in medical coding. Insurance carriers will deny for lack of specificity, sure, but they’re going to more quickly deny coding for procedures or service lines that aren’t documented. If you’re in a situation where the procedure or service line isn’t documented, don’t hesitate to query the physician and get it resolved.
Mistake #3: Using Outdated Code Sets
Another mistake new medical coders often make is failing to use current or updated code sets. Providers must purchase the next code sets yearly, so make sure you’re being provided the newest code sets to do your job properly. This mistake isn’t really your fault, per se, but you CAN do something about it.
Mistake #4: Under or Over Coding
The National Correct Coding Initiative Program (NCCI) was implemented for a reason: to improve the accuracy of medical coding. As such, you have NCCI software to help prevent you from over-coding or under-coding your service lines. Don’t become overconfident in your memory or abilities. Use the software!