{"id":14353,"date":"2021-09-30T17:56:14","date_gmt":"2021-09-30T17:56:14","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=14353"},"modified":"2026-05-11T14:12:22","modified_gmt":"2026-05-11T14:12:22","slug":"improving-medical-coding-quality","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/improving-medical-coding-quality\/","title":{"rendered":"Improving Medical Coding Quality"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Even though medical coding plays a crucial part in revenue cycle management, it is the most neglected process of medical billing. As per the study report, documentation and medical coding are considered to be the weakest processes of the revenue cycle in 2019. Accurate medical coding will ensure the claims will get out the door quickly and reimbursements will come back quickly. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">One of the main challenges of medical coding originates from the lack of medical coding specialists. The second challenge is insufficient communication between providers and coders. Due to the COVID-19 pandemic, many coders have to work remotely hence widening this communication gap between provider and coder. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">For improving medical coding quality, we discussed few possible solutions i.e., frequently performing quality audits, using technology, and opening communication channels.\u00a0\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Performing Quality Audits<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Frequently performing coding quality audits is an essential element for improving medical coding quality. As per a study report conducted by Change Healthcare, over $262 billion in claims are initially denied every year largely due to insufficient clinical information. The same study also found that $28 billion in the denied funds were directly linked to a lack of clinical documentation. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Monthly internal coding audits will prevent such \u2018soft\u2019 denials that require additional information for <a href=\"https:\/\/www.medicalbillersandcoders.com\/revenue-management-services.aspx?DivId=account-receivable\">reimbursement<\/a>. Performing quality audits will ensure that all coders are following payer-specific coding guidelines.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Frequent coding audits can identify areas that are leading to revenue leakage whether because of bad habits, workflow issues, or even lack of training. Coding audits will highlight any differences between your practice\u2019s billed data and the national average. This difference may be caused due to potentially fraudulent or non-compliant coding and billing practices. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Coding audits will also give your practice an outsider\u2019s perspective to your medical coding quality. For coding audits to be effective, they should be carried out regularly, the data should be stored in the proper format for comparing.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Use Technology<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Computer-assisted coding solutions can help you to improve the quality and accuracy of medical coding. Computer-assisted coding (CAC) solutions are software products that can analyze healthcare documents to identify the appropriate medical codes for clinical documentation. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">With computer-assisted coding software, there is no need to dig through coding books. This technology will automatically alert on CCI and LCD edits, and your coder will be presented with auto-suggested codes, which will in turn increase accuracy.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Opening Communication Channels<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Constant communication between provider and coding team is important as it will ensure that all procedures are documented properly, it\u2019s coded properly, and no procedure is missed considering it as a non-billable procedure. Providers should communicate audit findings and any changes in coding compliance with coders as soon as possible.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"> It will help coders to modify workflows immediately to improve coding quality. Communication also ensures coders are on the same page with updates to coding compliance, especially when so many coding updates are released.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Every year new codes are added, few codes are deleted, and some codes are revised. In years 2020 and 2021 we witnessed many revisions to coding that included changed telehealth guidelines, the addition of many new codes related to the COVID-19 vaccine and administration, and changed <a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/HospitalAcqCond\/Coding\">coding guidelines<\/a> for all payers. When such revisions happen, coders and providers should proactively work together to standardize coding processes.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Have a Coding Team<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For small practices, most providers prefer to handle medical coding all by themselves. But medical coding is not just choosing the correct procedural codes and billing them. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medical coding involves payer-specific documentation, accurately choosing procedural codes, choosing accurate modifiers as per clinical scenarios, <a href=\"https:\/\/www.medicalbillersandcoders.com\/revenue-management-services.aspx?DivId=denial-management-appeals\">appealing denials<\/a> with the required information, and coding audits to check compliance to payer coding guidelines. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">As providers are busy in inpatient care, they don\u2019t have sufficient time to keep track of coding updates and payer-specific guidelines. So, it\u2019s better to let coding professionals handle medical coding for you.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As providers move to value-based reimbursement, guaranteeing medical coding quality will be key not only for getting paid for services but capturing the quality of care delivered. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you need any assistance in improving medical coding quality for your practice, contact us at <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a> \/ <a href=\"tel:888-357-3226\"><strong>888-357-3226<\/strong><\/a><\/span><\/p>\n<h2>FAQs<\/h2>\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1761565546942\"><strong class=\"schema-faq-question\">1. Why is medical coding important for revenue cycle management?<\/strong> <p class=\"schema-faq-answer\">Accurate coding ensures claims are processed quickly, leading to faster reimbursements and reduced revenue leakage.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1761565562123\"><strong class=\"schema-faq-question\">2. What are the common challenges in medical coding?<\/strong> <p class=\"schema-faq-answer\">Challenges include a lack of <a href=\"https:\/\/www.medicalbillersandcoders.com\/medical-coding-services.aspx\">medical coding specialists<\/a> and poor communication between providers and coders, especially with remote work.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1761565572022\"><strong class=\"schema-faq-question\">3. How can coding audits help improve coding quality?<\/strong> <p class=\"schema-faq-answer\">Regular coding audits identify errors, bad habits, and training gaps, ensuring compliance and preventing denials.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1761565603667\"><strong class=\"schema-faq-question\">4. How does technology improve medical coding?<\/strong> <p class=\"schema-faq-answer\">Computer-assisted coding software helps improve accuracy by automatically suggesting codes and alerting coders to compliance issues.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1761565611658\"><strong class=\"schema-faq-question\">5. Why is communication between providers and coders important?<\/strong> <p class=\"schema-faq-answer\">Continuous communication ensures proper documentation, coding, and compliance, especially with frequent coding updates and changes.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Even though medical coding plays a crucial part in revenue cycle management, it is the most neglected process of medical billing. As per the study report, documentation and medical coding are considered to be the weakest processes of the revenue cycle in 2019. Accurate medical coding will ensure the claims will get out the door [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":14354,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-14353","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-coding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Improving Medical Coding Quality<\/title>\n<meta name=\"description\" content=\"Medical coding quality is a very crucial part of revenue cycle management to ensure clear claims and better reimbursement.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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