Common Medical Coding Errors and How to Avoid Them

Modifier misuse

Modifier 25 and 59 are among the most scrutinized. Use them only when documentation supports a separate service.

Lack of diagnosis specificity

Unspecified codes can fail payer medical necessity edits. Code to the highest specificity the record supports.

Unbundling

Billing components separately when a comprehensive code applies violates NCCI edits.

E/M level mismatch

Select office E/M levels based on medical decision making or total time, per current AMA guidelines.

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