Complete Story
10/16/2023
8 Medical Coding Mistakes that Could Cost You
Government and private insurers’ audits have revealed unfortunate cases of fraudulent or abusive medical billing practices. You deserve to be paid for the medical care you provide, but it is essential that you avoid improper billing practices to steer clear of trouble and maintain a flourishing practice.
When it comes to medical coding errors, they fall into the broad categories of “fraud” and “abuse.”
The former involves intentional misrepresentation. The latter means “the falsification was an innocent mistake, but nonetheless representative,” according to the AMA’s Principles of CPT® Coding, ninth edition. An example of abuse could involve coding “for a more complex service than was performed due to a misunderstanding of the coding system,” the text notes.
The AMA has several resources to help you accurately bill procedures and services with the Current Procedural Terminology (CPT) code set and Healthcare Common Procedure Coding System (HCPCS) codes.
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