Medical coding is a staple in any medical practice as it directly relates to the profitability of the center. However, even though coding is necessary for claims payment, it is often overlooked when reviewing the health of a practice. Many practices have outsourced this function making oversite of coding even harder. It is not until a practice has mounting denials or declining revenue that it is even given a second look.
Medical coding has changed a lot in healthcare and continues to evolve. Payers now use system edits ahead of claims processing that can deny or underpay a line item due to incorrect coding, wrong modifier usage or even an incorrect diagnosis code. It is difficult for even the most experienced coder, biller or manager to keep up with the changes. While most coding updates happen on an annual basis, payers have policy changes on coding all year long. To make it even more difficult, providers typically are not notified but must go to the payer website to obtain the updates.
It is important for practices to review coding on an annual basis to ensure they are coding correctly and being paid for the services they provide. This process becomes even more important if you have added any new services or procedures that new coding may apply. If you have not performed a coding review in sometime and would like our assistance, please contact us.