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Pediatric Coding Alert

Billing Errors:

One Medicaid Payer Reveals Its Top 5 Errors -- Know How You Can Avoid Making the Same Mistakes

Coding errors once again top the list of the most common mistake. Did you catch a miscoded service today before sending out a claim? You just missed making one of the biggest errors that Medicaid payers see. That's the word from one Medicaid payer's study of the most common errors submitted by medical practices. The "Medi-Cal Payment Error Study" researched the biggest errors submitted to California's Medicaid program in 2009, and found only a 5.45 percent error rate. Although that rate sounds fairly low, it represented over $1 billion in inappropriately paid claims. Physician claims were responsible for over 29 percent of the errors, with the following five areas representing the most common problems. Coding Errors In these situations, an incorrect code was reported for the service, either via upcoding, downcoding, or miscoding. The Medi-Cal study found that physicians made this type of error more often than any other, comprising [...]