BC Advantage - 2025 Issue 9

Medical Coding Errors That Could Cost You

Physicians deserve fair payment for the care they provide. To achieve that, accurate coding is critical. Errors in CPT or HCPCS coding can trigger denials, audits, financial penalties, or even allegations of fraud. Understanding the most common mistakes helps protect both your practice and your patients.   Fraud vs. Abuse in Coding   According to the AMA's Principles of CPT® Coding (9th edition), errors fall into two broad categories:   Fraud: Intentional misrepresentation. Abuse: Innocent mistakes that still result in inaccurate billing.   For example, abuse may occur if a coder selects a more complex service than what was...

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