Undercoding can definitely be a problem
When it comes to audit results, most compliance experts, providers, and coders worry about ?overcoding,? or reporting a service or procedure not sufficiently supported by documentation. Although overcoding is definitely a problem that doesn?t mean you?re making the right choice to ?play it safe? by deliberately undercoding, or reporting a lower-level service than is supported by documentation.
Undercoding also affects patients negatively, and skews the data that Medicare and other payers use to calculate payments, going forward:
Under coding misrepresents the true level care that is provided to Medicare beneficiaries. These statistics are used to calculate future Medicare payments and track trends in healthcare delivery. Patterns of under coding may be viewed as aberrant and open your practice up to audits and reviews. In addition, under coding impacts your practice revenue. You are not being appropriately paid for the level of service you provide to your patients. Correcting under coded claims means costly appeals.
Undercoding is no way to assure compliance in fact, it is, itself, a compliance risk. Rather, practices should strive to report services at the level supported by provider documentation, or ?right coding.??When one practices right coding, coding the level of service supported by your documentation, will win patients and the Medicare program.?