Impact of Improper coding
Medical coding is translating information such as diagnosis codes, procedures, and
patient information to insurance companies and other relevant authorities. Medical coding can be
complex and time-consuming. It is not an easy job. Improper coding is in accurately coding
services or procedures in a patient chart that did not occur. Throughout this paper, I will talk
about how improper coding has an impact on patients, healthcare providers, public health
information, as well as a biblical worldview on professional work ethics.
Impact of Improper Coding on Patients
Impact of improper coding on patients can directly impact the patient’s quality of care. It
also can lead to incorrect documentation of diagnosis, procedures, and treatments. It also affects
the provider and patients' relationship. Improper coding causes patients to become frustrated and
feel like they cannot trust their provider to handle their care properly. Examples of problems that
take place due to improper coding are inappropriate care due to incorrect diagnosis code, delay
of treatment, difficulty to obtain insurance coverage for procedures, and unexpected bills due to
wrong diagnosis code or extra codes. 2 Chronicles 15:7 “But you, take courage Do not let your
hands be weak, for your work shall be rewarded” (ESV,2020).
Impact of Improper Coding on Healthcare Providers
Compliance issues arise from improper codes, leading to accusations of fraud and abuse.
All healthcare organizations must adhere to coding regulations of the International Classification
of Diseases (ICD) and Current Procedure Terminology (CPT) codes. Improper coding can lead
to legal matters and potential investigations, audits, and cases brought forth. Loss of reputation is
another impact of improper coding for healthcare providers. It brings concerns about the
authenticity of the healthcare provider. For example, if the patient's diagnosis and plan of
treatment does not match it calls for questions about the patient’s health and all those involved.
Economic loss from improper coding leads to claim denials, under payments, and delay/denial of
reimbursements. An improper code on a procedure can create a difference of reimbursement by
$15,000. Improper coding can lead to loss of accreditation from the board and government
programs like Medicaid and Medicare. Psalm 90:17 “Let the favor of the Lord our God be upon
us and establish the work of our hands upon us; yes, establish the work of our hands”
(ESV,2020).
Impact of Improper Coding on Public Health Information
Public health information is any information relating to a patient’s condition, the past,
present, or future provision of healthcare or payment, there of (Cheng, 2009). Improper coding
affects public health information in many ways such as inaccurate information being sent out to
authorities that handle public information reporting. For example, a medical assistant put on a
patient’s chart that they tested positive for HIV; when the patient results are negative. The doctor
reports the positive status to the health department now the patient is listed in their database as
having HIV. The health department contacted the patient telling them it was reported that they
are HIV positive and to come in for further testing and instructions on medications, as well as
provide a list of all partners they have had sexual intercourse with. The patient is confused
because they are HIV negative. This improper coding led to a long open door of channels for the
patient and public health authorities. Now the patient must go through unnecessary steps to show
that they are in fact HIV negative, and that it was a wrong diagnosis. Proverbs 21: 3 “To what is
right and just is more acceptable to the Lord than sacrifice” (,2020).
Impact of Biblical worldview on Professional Work ethics
A biblical worldview can impact professional work in many ways such as respect,
fairness, moral compass, love, and honesty. Being fair and honest in the workplace builds trust
with the patients and credibility of your word. Respect is simple, workers should be treated with
respect as valued individuals. Love and moral compass go hand in hand. The Bible says love
your neighbor as you love yourself. Use your moral compass with your ethics to guide yourself
and the patient. Remember as Christians, we are always held to a higher standard than others.
We often go beyond what is morally right to biblical ethics. Our professional work ethics are
framed by our worldview.
Consequences of Improper Coding
•Fraud and abuse fines
•Legal consequences
•Claim denials and reimbursement denials
•Damage to reputation
•More administrative tasks and paperwork for providers and staff to complete to
fix the wrong codes.
•Patient care disruptions
•Wrong services provided to patients leading to lawsuits and unexpected bills.
Ways to Prevent Improper Coding
•Hire experience medical billing and coding staff
•Perform quality checks randomly
•Follow an end-to-end process to decrease coding errors
•Invest in quality training an education for employees
•Stay up to date with coding guidelines using updated codebooks and software
•Maintain detailed documentation
Conclusion
In conclusion, improper coding affects everyone, not just patients. It is critically
important to know how to call correctly to keep mistakes from happening. Colossians 3:23-24"
Whatever you do, work hardly, as for the Lord, and not for me, knowing that from the Lord, you
will receive the inherent as your reward, you are serving the Lord Christ” (NIV,2020). Simply
means do your work with honesty and integrity, morals, ethics, and conscience to do the right
thing even if it takes more time. Be sure to properly code the services and procedures for not
only the patient and provider, but for you as well, because if something happens because of your
improper coding, you can be just as liable as the providers.
References
Biblegateway. (2020). English Standard Version.
https://www.biblegateway.com/passage/?search=2%20Chronicles%2015%3A7&version
=ESV
Biblegateway. (2020). English Standard Version.
https://www.biblegateway.com/passage/?search=Psalm+90%3A17&version=ESV
Biblegateway. (2020). New International Version.
www.biblegateway.com/passage/?search=Colossians%203%3A2324&version=NIV#:~:t
ext=Whatever%20you%20do%2C%20work%20at%20it%20with%20all%20your%20hea
rt,Lord%20Christ%20you%20are%20serving.
Biblegateway. (2020). New international Version.
https://www.biblegateway.com/passage/?search=Proverbs+21%3A3&version=NIV
Cheng, P. (2009). The risk and consequences of clinical miscoding due toinadequate medical
documentation. https://pubmed.ncbi.nlm.nih.gov/19293434
HIPPA journal.(2022). What is considered PHI? https://www.hipaajournal.com/considered-phi-
hipaa/#:~:text=To%20simplify%20a%20definition%20of,of%20healthcare%2C%20or%
20payment%20thereof. Accessed June 12, 2024
O’Reilly,K. (2023). 8 Medical coding mistakes that could cost you. https://ama-
assn.org/practice-management/cpt/8-medical-coding-mistakes-could-cost-you
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