What is one consequence of coding errors?

The denial of payment from insurance providers is a significant consequence of coding errors. When medical codes are inaccurately assigned or do not match the services provided, it can lead to discrepancies in billing. Insurance companies rely on accurate coding to determine the legitimacy of claims and to process payments effectively. If the codes submitted do not correctly represent the patient's condition or the treatment rendered, insurers may deny the claims altogether or request additional information, leading to delays in payment or non-payment.

This issue also affects healthcare providers, as they may face financial difficulties due to delayed revenue from incorrectly coded services. Ensuring proper coding is therefore critical not only for compliance but also for the financial health of healthcare institutions. The incorrect assignment of codes can result in complications that impact overall operations, including increased administrative burdens and the requirement for appealing denied claims, further complicating the revenue cycle.