Skip to main content

Avert These Common Medical Coding Errors -Avontix



Medical coding is a critical process that requires accuracy in order to settle the insurance claims quickly. However, errors may occur in coding that lead to higher or lower payments by insurer which result in legal and financial implications for the health care provider. We will figure out few errors that are common and should be avoided in medical coding jobs.

Under coding:  Due to the complex documentation guidelines and procedures in E/M coding, health care providers often find it difficult to select appropriate codes for the services. In order to avoid claims being denied they often tend to do under coding. They feel safe to undercode because they need not do considerable documentation which may be difficult for them. However, with this practice of undercoding, health care providers may lose huge amounts of reimbursement. Hence, medical coding services professionals should regularly keep on updating themselves with coding guidelines and learn how to select an appropriate level of E/M services.

Missing charges: Many times it may happen that medical coders miss to code minor procedures or code them incorrectly.  While using templates in the system, they may not find the code for a procedure. These result in failure to capture charges for services provided and denial of claims from insurers and thus bring revenue loss.

Missing modifiers: Medical procedures are very complex by nature and require additional information to code the patient’s visit accurately. The codes for this kind of additional information can be found in modifiers of CPT and HCPCS codes. It is often found that modifiers have an important role in reimbursements and if they are not used appropriately, it may lead to loss of revenue. It is also found that different payers have their own guidelines for the usage of modifiers. Hence, for people in medical coding jobs, it is critical to understand these guidelines to minimize revenue loss by maximizing the reimbursements.

Unbundling: This refers to the way a medical procedure is divided into separate parts and coded when the whole procedure itself has a comprehensive code. This means that a coding duplication of a procedure is happening which is both unethical and illegal and will be traced in audits. This will result in legal implications. Hence, professionals in medical codings ervices should be aware of individual codes and the comprehensive codes in order to avoid unbundling.

Highest level coding missed: Medical coders have to ensure that they code to the highest level of specification. They have to see that they get the maximum information from the providers and use it accurately while coding. For this purpose, they ought to know the terminology for both medical procedures and diagnoses and their relevant codes. If this is not taken care of and coding is done at a general level, highest level coding is missed which results in claims being rejected or denied.

Not using updated codes: The coding manuals are generally updated every year. So, it is the responsibility of the medical coders to update their knowledge regularly and use the codes correctly and sharpen their skills on a continuous basis.


Stay sharp and up-to-date in your codes, so that you don’t make errors in coding and get ahead in the profession of Medical coding. The only way to become a top notch medical coder is to remain a learner throughout your career. Keep learning all the new medical terminology related to the diseases, illnesses, treatments and procedures and their respective codes.

Visit: Avontix
Post a Comment

Popular posts from this blog

That’s Hilarious! Funny Must-Read Medical Transcription Errors!

Doctors every now and then come across some very critical bloopers from medical transcriptionists. Some of these can be downright funny! It’s common for transcription errors to creep in for various reasons like the dictation might not be clear, too many medical terms stuffed in, or misunderstanding at the transcriptionist’s end. Medical transcriptionists vary in experience and skill and may not be well versed with some medical terms. Here is a compilation of some very funny transcription mistakes you could note to avoid being on the receiving end of the laughter! 

   ·"Eyes and nose continue to be within normal limits" (I & O).    ·"History of sick as hell disease" (sickle cell)    ·"She was a bitch and grinned" (a bit chagrined).    ·"The last day the patient took their meds was for beaver."  (forever).    ·“49 year old occasional male”(Caucasian male).    ·“Borderline respectable pancreatic cancer”. (Resectable).    ·“Patient is alert and orien…

Working in the night shift? Here's how you can be double productive! -Avontix

Waking up and stretching at 4 PM. Having breakfast around 6 PM, rushing to office at 8 PM, when others are having a cozy dinner with family. Is this you?
Although there will be initial hiccups in adjusting to the night world, with time we understand that night shift work can be as smooth as day shift, provided we take care of few things.
Train your mind: The first and foremost feeling that we have to inculcate in us is that we are not doing anything different from routine. We ought to get used to and train our mind that night shift life is similar to that of the day shift life. With this. it gets much simpler for us to get accustomed to the new lifestyle. Winning our mind is winning half the battle.
Eat healthy: Work schedule affects our eating habits and vice versa. With sudden changes in work timings, our eating pattern gets disturbed and this results in health disorders which in turn reduce our productivity.
Pack home food:  Be a little stringent with yourselves and pack home cooked …

Location isn’t a Matter for Coding and RCM -Avontix

The technological developments in the healthcare management industry have facilitated and increased the outsourcing of medical coding and RCM among many healthcare facilities. The healthcare facilities need not bother about from where the support for their RCM and medical coding jobs is coming from. What they need to think about is only if these service providers have the latest technology, training and subject expertise. These days most of the outsourcing companies are well equipped with high-speed internet connectivity, coding and RCM software with security features that make the importance of the location of the service provider negligible.
The lower reimbursement rates and diminishing margins are forcing the different healthcare facilities to think for ways to reduce costs. One of the best ways for hospitals and other facilities to minimize costs is outsourcing their medical coding jobs along with their revenue cycle management. The significant task for a hospital is to identify …