Getting Your Ob-Gyn Claims Paid With Correct Coding

Getting Your Ob-Gyn Medical Billing Claims Paid With Correct Coding

There was a medical billing study done at the University of Illinois Hospital from 1999-2001. This was a study to see how many coding errors occurred in patients admitted for eclampsia and preeclampsia during this time. The study was astonishing. There were 67 total errors in this one study. Medical billing coding errors frequently happen with ob-gyn patients.

Surprisingly, in this medical billing ob-gyn study, over 80% of the coding errors happened with clinicians. That means actual doctors were, and are, incorrectly coding ICD-9 codes and CPT codes. Most of the time people blame the actual coder instead of the clinician. However, in this study, 34% of the errors involved the coder in any way. This does mean that coders made quite a few medical billing mistakes, but the clinicians have a lot more work on their hands.

Doctors go through years and years of schooling. They do not lack in clinical skills, but some of them lack in medical coding abilities. To them it is more important to treat a patient correctly then to code their diagnosis correctly. In many ways this is correct. However, without correct coding, incorrect medical billing will be performed. This can lead to under payment or an audit investigation. Neither option is desirable.

It is important when diagnosing and ob-gyn patient to document all pertinent information in the medical record. This is imperative to the accuracy of the medical billing. Many errors happen because a clinician is too vague or general in the descriptions. It is important that anyone and everyone is able to understand the medical records written down.

Coding and medical billing are two processes that cannot be guessed. They must be completely accurate in order to get payment for medical services. To ensure correct medical billing, be sure the coding for ob-gyn claims is accurate.

View all Articles by: Melissa Clark, CCS-P