Hcr 220 Check Point Wk 2 Day 5
Submitted by dorian on May 11, 2011
- Category: Science
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Hcr 220 Check Point Wk 2 Day 5
Errors and Compliance in coding
Health care payers often base their decisions to pay or deny claims only on the diagnosis and procedure codes. The integrity of the request for payment rests on the accuracy and honesty of the coding and billing. Incorrect work may simply be an error, or it may represent a deliberate effort to obtain fraudulent payment. Some compliance errors are related to medical necessity; others are a result of incorrect code selection or billing practices.
Errors Relating to Code Linkage and Medical Necessity
Claims are denied for lack of medical necessity when the reported services are not consistent with the diagnosis or do not meet...
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