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ICD-10 accuracy: How to make the most of coding audits

Carl Natale
by Carl Natale
ICD-10 accuracy: How to make the most of coding audits

Recent surveys don't show any big problems with ICD-10 coding accuracy. That could be because of some unspecified leniency by healthcare payers.

Even if a medical practice genuinely feels it's on the ball, a coding audit could help make sure coding procedures are on the right course and find a little bit more room for improvement.

Jonathan LaFleur and Julie Boomershine take a look at how to get the most out of coding audits:

  1. "Set realistic expectations:" A drop in accuracy is very possible.
  2. "Dive more deeply into audit findings:" Don't assume coding errors are the result of ICD-10 implementation. Really look for what's driving the errors.
  3. "Monitor unspecified codes:" It may be good for now, but sooner or later healthcare payers are going to require specificity. Really.
  4. "Validate 4th and 5th characters:" For example: Does the documentation support laterality or are medical coders guessing? There's a 50-50 chance they will be correct.
  5. "Consider the effects of computer-assisted coding (CAC):" Automation doesn't solve everything but it could help accuracy.

Don't just use the coding audits to look for mistakes. This is an opportunity to check for specificity before healthcare payers start denying medical claims that are good enough now.