Medical Billing & Medical Coding Blog...

Medical Billing » Blog » Is Your ADL Coding Accurate?

Is Your ADL Coding Accurate?

Is Your ADL Coding Accurate?

Will inaccurate activities of daily living scores hurt you? You bet. ADL coding is something that auditors will be watching heavily and if you’re not calculating yours correctly, you’ll penalized and fined.

One way to make sure your facility is well within the guidelines of billing permissibly and ethically is to do a RUG profile of your residents and compare your facility to the state and national averages. You can compare at your facility to the other agencies in your state and against the national averages at the Centers for Medicare & Medicaid Services Web site (

If you find that your facility has far fewer rehab RUGs ending in C’s and far more A’s than the national or state average, than it’s fair to assume that your building is probably downcoding ADLs and you’re missing out on reimbursements.

It’s a fine line and you need to check your facilities ADL scores on a regular basis or you could be billing incorrectly. That’s important to do because “if you accidentally upcode where the person goes into a higher paying RUG, you can get in trouble and owe Medicare (or Medicaid) money. Frequent checking will help you avoid this issue.

Check your records on a regular basis and ensure you both coding correctly and getting maximum reimbursements for your services to patients.

View all Articles by:

Both comments and pings are currently closed.

Be The First To Comment!

New comments are no longer accepted on this article.

Subscribe To Article Updates By Email

Submit this form to receive an email when a new article is published to our blog.

Your email address:

(Your email will never be given or used for anything but this article subscription) - privacy policy

Blog Sections
Blog Archives
Professional Affiliations
Connect With Us
The medical billing blog with billing and coding articles!
Medical Billing & Coding Articles!