The Impact of Inaccurate Coding on the Healthcare Facility
Inaccurate medical coding has negative effects on the healthcare facility, including lost time, increased follow-up costs and decreased reimbursements. It also affects the relationship between the provider and the patient.
If you are a medical practitioner, you must keep up to date with changes in coding regulations. Medical practices can't achieve revenue targets or stay ahead of their competitors without accurate coding. Coding accuracy will become even more important as value-based reimbursement expands.
The ICD-10 and CPT codes inform insurers about the services performed. They must be appropriate for each diagnosis, and a slight variance indicates specificity.
The Centers for Medicare and Medicaid Services (CMS) make quarterly changes to the codes. These changes are intended to promote cost-effectiveness. However, these changes can also create confusion.
When a physician lists a code for a procedure that is more expensive than what was actually performed, he is causing overbilling. This type of billing is considered a form of fraud.
There is a high chance that your practice will be rejected by insurance carriers for improper coding. Having to resubmit the claim can take a long time and place a burden on your practice.
Inaccurate coding is also risky for patients. The wrong diagnosis can lead to misdiagnosis or inappropriate care. Patients' trust in their health care providers is diminished.
To avoid these consequences, medical establishments should take pre-emptive measures. For example, hiring a professional company to handle the coding of your claims can help you avoid costly mistakes.
