The Cost of Coding Errors & How Your ASC Can Avoid Them

Any ASC (Ambulatory Service Center) that fails to give its coders regular CPT code training runs the risk of incorrect coding. Not only can these coding errors cost an ASC money, but they can also have a negative impact on the quality of patient care.

The cost of coding training is often pennies when compared to the chunk of money lost from a medical coding error

Coding Errors and Patient Care

A good example of a coding error negatively affecting patient care is when the coder uses the wrong diagnostic code. That single code error is a minor detail that can make a major difference in the care of a patient. For example, a missing or incorrect modifier code for a patient’s knee injury could cause an MRI study to be carried out on the left knee instead of the right one, or vice versa. 

The Financial Implications of Coding Errors

Coding errors can have a severe and direct impact on an ASC’s billable income. Not only can payments be denied, but they can also be delayed or only be paid in part. Many claims are denied or rejected when they’re first submitted. Whether these claims will ever be paid depends on the organization’s ability to correct the errors and resubmit them in a timely manner.

How Your ASC Can Avoid Coding Errors

Your ASC is a busy place, and that’s even more reason for ensuring your medical billing and coding is done right the first time around. Errors happen because your staff are human, but mistakes should be avoided as much as possible to ensure you’re collecting all the revenue you’ve earned. If you’re struggling with coding errors at your ASC, there are a number of reasons why, but there are steps you can take to get a handle on it. 

 

Training and oversight. One of the biggest causes of coding errors is staff members who are not 100% familiar with the coding system. You need trained, qualified staff working with your coding. This is particularly relevant in the case of relatively new or temporary employees. While it’s true that training costs money, the training cost is often pennies when compared to the chunk of money lost from a medical coding error. 

 

A proper system of oversight should also be in place where an experienced staff member verifies that the codes entered are correct. If mistakes are found, the employee in question should be shown the error, taught how to fix it, and then be provided with additional training.

 

It’s also important to make sure your employees use the latest medical coding manual. The guidelines for medical coding are updated pretty regularly, so if your ASC isn’t using the latest coding manual, errors are a given. 

 

Have systems in place to prevent overcoding. This term refers to when the medical coder uses a code that relates to a procedure with a higher reimbursement rate than the one actually performed. For instance, if a procedure was performed by a technician, but is coded as having been performed by a doctor, then that would qualify as overcoding. Not only can this lead to claims being rejected, but it can also cause your ASC to be penalized or audited.

 

The solution is to have effective internal control systems in place to pick up these errors before they can do major damage.

 

With every code entered, you put your revenue and reputation at risk. It’s imperative to have skilled medical coders working at your ASC to avoid big mistakes that can hurt your patients and organization. 

Improve Your ASC’s Billing and Collection with Professional Medical RCM Services

Your medical department, which includes billing and coding, is responsible for maintaining the finances of your ASC. That’s a huge responsibility, and it’s a tough job that forces staff to deal with many different challenges, from rejected claims to claim disputes.

 

Need some help getting finances in order at your ASC, or want to hand the work over to an outsourced team? Schedule a quick consultation with our revenue cycle management professionals. As a healthcare RCM company, we understand that the process is complicated and overwhelming. We’ll help you get your numbers right where they need to be so you can enjoy an efficient, streamlined collections process from beginning to end.