The integration of the latest technologies has changed medical billing and coding over the years. Using automated systems significantly decreases the workload, however, there are still many tasks that require manual work. Due to the sensitive nature of data, concentration and a good level of expertise are important. Either way, errors are possible, and a medical billing professional has to try to prevent them.
Can Technology Reduce Errors In Medical Coding
You are probably wondering how technology can reduce errors in medical coding and billing. The truth is that machine learning and artificial intelligence don’t reduce the chance for common errors. Although they make many processes easier, technology cannot completely take over the role of experts.
Since the consequences of inaccurate coding and billing can be extremely costly or compromise patient care, professionals have to be very careful. To avoid mistakes, medical billing and coding experts should patiently double-check the information they input. They need to have a good understanding of medical billing codes, as they change all the time. Extra training on the most common reasons for medical claim denial is another effective method for the prevention of errors.
Common Errors In Medical Billing and Coding
Before looking into the usual mistakes, let’s define what medical coding is and how it differs from medical billing. The process of medical coding requires using classification systems to translate relevant documentation into codes. In other words, the coder needs to accurately substitute a physician’s diagnosis or prescription, with the corresponding codes.
Medical coders engage primarily with financial and technical aspects of the medical world. In contrast, medical billing experts are responsible for submitting claims to insurance companies and payers. Due to the different nature of the two practices, there are specific errors relevant to each. However, medical billers must have coding knowledge in order to submit claims properly and investigate denied claims.
Frequent medical coding mistakes could vary from something as simple as a typo to reporting unlisted codes without documentation. Since every symbol matters, knowing and providing the valid procedure codes is essential. In contrast, errors in the medical billing process could be related to missing or inaccurate information.
For instance, issuing duplicate bills, mismatched invoices, or failing to provide sufficient details to support a claim. Upcoding is another bad practice that occurs when a health service or treatment bill is more expensive than it should have been. It often results from referring to a more serious diagnosis or condition than the actual one.
4. Technical Updates in Medical Billing and Coding
The CPT and ICD code sets are globally recognized medical codes used for defining specific services and conditions. The Current Procedural Terminology (CPT) codes signify medical services and procedures to increase accuracy and efficiency.
The International Classification of Diseases (ICD) codes set the international standard for defining and reporting diseases and health conditions. They allow the world to compare and share health information using a common language.
As you already know, medical codes are changing quite often. Amended and deleted codes are released every year. That is why staying on top of the latest updates is important for error prevention.
For instance, the transition from ICD-9 to ICD-10 codes was necessary for achieving more clinically accurate content and less restrictive coding structure, as well as enhancing the data quality. Another good recent example is the release of emergency ICD codes in response to the COVID-19 outbreak.