Top Three Reasons for Coding Errors During the COVID-19 Pandemic

The physician executives at Paramount Health Solutions have a combined 35 years of experience in DRG validation and clinical documentation improvement (CDI), and have reviewed more than 200,000 inpatient records. Dr. Bilal Mushtaq, M.D., who serves as Chief Operations Officer for the company, offers the top three reasons why coding errors are happening as a result of COVID-19.

  1. COVID-19 has forced fewer elective tests and procedures in hospitals, and CDI departments have felt the impact. Workers have been furloughed, laid off or have had their hours reduced. The result is less thorough and less specific documentation of charges that need to be billed.
  2. The CDC, AHIMA and other governing bodies changed numerous coding guidelines in April to reflect COVID-19 patients. It has become very important to capture that specific new coding now that CMS has allowed hospitals to add it as a secondary diagnosis. It doesn’t always change the reimbursement, but it affects the true clinical picture of population health from a quality standpoint.
  3. Some coding staffs are now working remotely and are busier than ever with the spikes in coronavirus-related hospitalizations and have less time for continuing medical education to keep up with coding changes such as those reflected above.

The experts at Paramount Health Solutions use proven methods and advanced technology to partner with hospitals of all sizes throughout the U.S. to ensure accurate, complete and timely clinical documentation and coding to capture a true clinical picture. They can help “bridge the gap” that may be happening with coding accuracy in the time of COVID-19. “We provide a second level of review and oversight to make sure there aren’t barriers or revenue leakages from a lack of communication or attention on documentation and coding,” Dr. Mushtaq said. “It’s our job to keep up with all the latest coding changes.” He also said that his team provides ongoing medical education to providers and other staff at their client hospitals, both live webinars and recordings, to help CDI departments stay up to date with new standards. “Our results are better patient care, more accurate population health statistics, and optimized revenue streams,” Dr. Mushtaq said.