Questions On Correct Billing And Coding

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In order to be a better or more knowledgeable about correct billing and coding, the coder must first be aware of the impact of the issues that can occur in a claims process when incorrect information is documented or coded about the patient.
The main possible impacts of incorrect information in a claim are: rejected claims, down-coding of the bill by the insurance company, loss of payment to the physician and additional audits.
During a patient visit, all that is done for the patient must be transcribed into the correct codes. Along with these codes, there must be sufficient supporting information documented in the patient record. When the supporting evidence is not there, that line will either be down-coded or the billing being rejected. A rejected bill requires more time and effort by the physician’s staff to correct the issue and resubmit it. Billing with the correct primary, sub and supporting codes will prevent the extra work and possible loss of money. This is not just an ethical and financial need to do so, but a legal responsibility. In many cases, the coder is held responsible for incorrect or erroneous billing.

Correct and Clean Coding Other than the ethical issues of coding, the best methodology to follow is to code by these three coding guidelines. a) First, code the primary diagnosis, condition or reason for the visit followed by the co-existing, current circumstances. b) Next, with the supporting evidence, code to the highest level you are most
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