O'Malley et al reported a number of coding errors that may occur when a coder translates a diagnosis or procedure into the correct billing code.
Types of errors:
(1) creep errors (involving a failure to conform with rules for assigning the codes)
(2) upcoding or downcoding (correct code identified, but the code assigned has a greater or lesser reimbursement)
(3) unbundling (coding for various elements or parts rather than the correct overall diagnosis or procedure taken as a whole)
Creep errors may involve:
(1) misspecification (failure of codes to match the documentation in the medical record)
(2) miscoding
(2a) using a generic code when a more specific code is available
(2b) assigning an incorrect code according to the rules
(2c) assigning a code that is not attested to by the physician as accurate
(3) resequencing of primary and secondary diagnoses (coding a secondary diagnosis as the principal diagnosis)
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Purpose: To identify possible errors in the codes assigned for a patient's care.
Objective: administration, failure handling and therapy escalation
ICD-10: Z63.8,