Coding Errors [Healthcare Compliance Tips]

Review, provide real-world examples, and quiz your staff about the most common medical coding errors identified by the American Medical Association (AMA).

Here are 8 of the most common medical coding errors found by the AMA:

1. Unbundling codes
2. Upcoding
3. Failing to check National Correct Coding Initiative (NCCI) edits when reporting multiple codes.
4. Failing to append the appropriate modifiers, or appending inappropriate modifiers.
5. Overusing modifier 22-increased procedural services.
6. Improper reporting of the infusion and hydration codes, which are time-based.
7. Improper reporting of injection codes.
8. Reporting unlisted codes without documentation.

Use the information the AMA provided to your advantage by creating review sessions with your staff that includes real-world examples and “Check Your Knowledge” quizzes.

When you share real-world examples, it exhibits that you value employee learning and that you took the time to choose something new, rather than recycled examples from previous years.

Quizzes are another avenue to help you test their knowledge and boost their motivation, especially if they score well.

Remember, mistakes will happen.  But, it is critical that you ensure proper billing practices are the focal point to avoid fraud and increase your return on investment.

**The opinions and observations from the group/author are not a promise to exempt your practice from fines and penalties.  Research, modify, and tailor the advice to fit your specialty.