by Dr. Yashashwini Reddy | Jun 17, 2025
→ Including Upcoding, Unbundling, Modifier Misuse, and More ❌ 1. Upcoding What It Is:Reporting a higher-level service than what was actually performed to receive higher reimbursement. Example:Coding a moderate-level visit (99214) when the documentation supports only a...
by Dr. Yashashwini Reddy | Jun 17, 2025
1. ICD-10 (International Classification of Diseases – 10th Revision) Use: To represent diagnoses and medical conditions. Example: E11.9 – Type 2 diabetes mellitus without complications. Why It Matters: Essential for documenting why a patient received...
by Dr. Yashashwini Reddy | Jun 17, 2025
→ Roles, Responsibilities, and Workflow Distinctions Medical coding and billing are two essential, yet distinct processes in the healthcare revenue cycle. Both work together to ensure that healthcare providers get paid for services rendered—but their functions are...
by Dr. Yashashwini Reddy | Jun 17, 2025
Medical coding is the process of translating healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes. These codes are taken from medical record documentation such as physician’s notes, lab reports, and radiologic results....
