Alliance Medibilling CEO Annette Bolcato drew on her 25 years of experience in the medical field to share four common coding and billing mistakes with Becker's ASC Review.
1. Using incorrect modifiers
Using modifiers incorrectly is a common error. The frequently misused modifiers 25 and 59, for example, are red flags for insurance carriers and often prompt audits.
2. Undercoding or overcoding
"A lot of offices feel that they're a little more concerned about overcoding something, so what they'll do is undercode. And they think since they're not going to get as much money from the carrier that’s OK, but that's a big mistake," Ms. Bolcato said.
3. Failing to provide sufficient documentation
There's often not enough documentation for what has been performed, according to Ms. Bolcato. Providers might only bill out one code, leaving off several other codes that could be billed out.
4. Treating billing and coding as the same job
Billing and coding are distinct jobs that require in-depth knowledge. "A lot of practices feel as if billing and coding are the same thing. They're two different animals," Ms. Bolcato said. "We need the expertise of both people."