National Healthcare Spending in the U.S. Was Nearly $5 Trillion (with a “T”) in 2023 – New...
Health Populi December 18, 2024
Demystifying Coding Compliance: 3 Key Strategies for Navigating the Regulatory Waters of RCM
MedCity News April 28, 2024
Organizations must take a proactive approach by implementing a comprehensive education program, internal audits, and automation technology.
Noncompliant coding is a more significant risk to the revenue cycle than providers may realize, accounting for $36 billion in annual lost revenue, denials, and fines. In 2019 alone, the CMS and the HHS Office of Inspector General (OIG) imposed fines and penalties for coding noncompliance of $2.5 billion and $3.7 billion, respectively.
What is coding compliance?
Coding compliance includes the processes that ensures the “coding of diagnosis, procedures and data complies with all coding rules, and regulatory guidelines.” Because lack of coding compliance falls under the “fraud and abuse” category of the American Medical Association’s Principles of CPT® Coding, it is...
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