Common Medical Billing and Coding Errors You Need to Know

medical billing and coding professional

As an administrative professional in a medical office, you’ll use medical codes to bill patients so healthcare providers are paid for their services. But did you know that there are thousands of medical codes from which to choose? Understanding what they all mean can seem like learning a foreign language. It might sound overwhelming, but with the right training, you’ll be able to keep them all straight to find the right code for every diagnosis and medical procedure. 

But to be successful as a Medical Biller and Coder, you will need to know the common mistakes that could cost providers and patients time and money and cause everyone unnecessary confusion.


Five of the Most Common Billing and Coding Errors

  • Unbundling

Unbundling occurs when you list charges separately that should be billed together. This results in a patient’s bill being higher than it should be. It’s caused by misunderstanding that certain codes are part of the same procedure. An example would be if you billed an incision and stitches that were part of the same surgery separately.

  • Patient Information Error

When you file a claim with incorrect patient information such as a misspelled name or a wrong insurance number, the insurance company could reject it. This could lead to a delay in payment and a loss of productivity due to the hassle to correct it. It could also cause the wrong patient to get billed.

  • Duplicate Billing

Sometimes billing confusion causes a patient to be billed multiple times for the same service. This can happen when both a doctor and nurse bill the patient for the same prescription. It can also occur when a patient reschedules an appointment, but you accidentally bill them for the old and the new appointment.

  • Not Linking Codes

All medical codes must be linked to a diagnosis code, which provides the reason why medical services are performed. Errors can occur when a patient receives multiple services in the same visit. You will need to properly label the diagnosis code as the reason for the visit and code any other services unrelated to the reason for the visit separately.  

  • Entering the Wrong Digits

If you incorrectly enter numerical data such as birth dates or insurance information, it can cause a claim to be denied and delay payment.


How to Avoid Billing and Coding Errors

  • Stay Current

Remain up to date on the latest in billing and coding procedures. New codes can be introduced, and it’s important to be aware of these new codes to avoid making mistakes.

  • Double Check

When you enter a claim always double check to make sure you correctly entered codes and that all patient information is accurate.

  • Follow Up

After you submit a claim, follow up to see if the insurance company has any questions. They might be able to notify you of any errors, which can help you fix them and re-submit a correct claim in a timely manner. This could prevent payment delays.


Do you have the attention to detail required to be a Medical Billing and Coding specialist? Career Quest Learning Centers can provide you with comprehensive training to get started on the path to this rewarding career. Fill out the form or give us a call in Lansing at 517-318-3330, in Jackson at 517-990-9595 or in Mt. Pleasant at 989-817-4431 today.




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