What would happen if we do not adhere to coding guidelines?

What would happen if we do not adhere to coding guidelines?

Inaccurate medical coding will cause your reimbursements to get delayed, denied, or only partially paid. Build up a cache of delayed reimbursements and you’ll have mounds of paperwork, stress, and lost revenue for your emergency medicine practice to deal with.

Why is diagnostic coding important?

The diagnosis code supports medical necessity and tells the payer why the service was performed. The diagnosis code supports the medical necessity for the service and tells the payer why the service was performed. It can be the source of denial if it doesn’t show the medical necessity for the service performed.

What are the consequences of failing to perform code linkage?

A lack of code linkage or code linkage that does not demonstrate medical necessity will prevent a medical practice from getting paid. Digit Transposing A small error of transposing digits can cost a medical facility.

What happens if they do not follow the practice of compliant billing?

Inaccurate billing and coding can have serious financial consequences for your business. Often, it will result in your practice not receiving the full amount it is entitled to from the patient and/or insurance company. Inaccurate or noncompliant billing and coding can also leave your practice vulnerable to a lawsuit.

Why is it important for medical practices to follow the practice of compliant billing?

When your practice is compliant with all medical coding protocol, it is much easier to ensure that billing to patients and insurance is accurate. Accurate billing will help with making important business decisions that may involve staffing, patient outreach, and adding service lines to your practice.

What are consequences of non-compliance?

Non-compliance leaves you at risk for financial losses, security breaches, license revocations, business disruptions, poor patient care, erosion of trust, and a damaged reputation. Here is a quick overview of the impact of non-compliance.

What are the consequences of inaccurate medical coding?

It is the foundation of every practice to provide quality patient care. Inaccurate medical coding can interrupt that goal, leading to frustration and confusion and a potential breakdown of the relationship you have built with valued patients.

When to use unbundling codes in medical coding?

Here are some of the most common mix-ups to avoid in medical coding. Unbundling codes. When there is a single code available that captures payment for the component parts of a procedure, that is what should be used.

What causes a coding error in a CPT book?

Failing to read the editorial comments at the start of the section in the CPT book or the notes near the code is another cause of this type of error, as is not reading specific coding companions available to assist in special circumstances. Failing to link diagnosis codes.

What are some examples of medical coding mistakes?

Example: You excise a lesion located in the crease of the neck of a very obese patient. The obesity makes the excision more difficult. In such a case, appending the modifier 22 to the code used to report the removal can indicate the increased complexity of the service. Improper reporting of the infusion and hydration codes, which are time-based.