Hcr 200 Week 7 Checkpoint

Sarah Hall

HCR 220

November 5, 2012

Errors and Compliance in Coding Checkpoint

The most common causes of errors in coding and billing are typos, incorrect dates, and double billing. Typos, or typing mistakes occur when entering a patients name or address or other PHI. Incorrect dates are only a small part of a couple different errors. For example, a patient could have only been in the hospital for seven days, but get charged for nine. Another example is that a patient could have undergone surgery that took only one hour, but charged for three hours. Double billing can occur when the patient’s health care provider tries to bill a patient for two separate procedures when they really only actually received one.

There are a couple of different ways that errors in billing and coding can be solved. One way of doing this is that the patients need to be proactive in examining their eobs and bills when they receive them. This will help them to be certain that the statement didn’t have any typos, incorrect dates, or double billing. If the patient is reviewing their file and does happen to find an error they are able to write a letter outlining the problem and offer them the correct information. If, for some reason the patient doesn’t get a response, the patient will then need to get in contact with the health care provider. If no action is still taken after that the patient should contact his or her state’s consumer protective office.

Improper coding can lead to incorrect payment for Medicare claims which is controlled by the Medicare National Correct Coding Initiative (CCI). The coding policies of the CCI are derived from the coding guidelines of national medical societies: Medicare’s payment policies and coverage (national and local); Medicare’s analyses of standard surgical and medical practices; and CPT coding conventions. Thousands of CPT code combinations are used by Medicare’s system computers for checking claims. The CCI is able to prevent...