DME (Durable Medical Equipment), is typically reusable equipment that’s used for long-term healing. It is experiencing extraordinary growth. The senior population is very fond of it, and so is the demand. DME billing has undergone some changes. The DME billing system can be complex. A physician could suffer significant financial losses if DME billing is incorrect.
Coding Errors in DME Billing
Medical coding is essential when DME billing is concerned. This is a major error in the billing process. Any errors in this area could lead to incorrect service being displayed, as each medical document resembles a different number. These are some of the errors that you should avoid before you submit a claim.
Upcoding Errors
When patients are charged for more expensive and complex procedures than they actually received, this is called upcoding error. These errors are caused by an error in the diagnosis and treatment codes entered by DME billing staff.
Incorrect Procedural code
Simple slips of the fingers can lead to major data entry problems and alter the procedure codes. This is most common when DME-related information from encounter forms or other supporting documents is incorrectly documented.
Unbundling Errors
This means that the DME diagnosis procedure is divided into smaller procedures. Each procedure is coded and billed separately if there is one code that covers the entire procedure. This is an unethical way to bill a patient. It could lead to an audit. It is important that medical coders be aware of this error.
No Specific
To achieve the highest level of specificity, some ICD-9 codes need a fourth or fifth number. The claim will be rejected if this section is not filled in. The coder should verify his facts by consulting the codebook and the internet if he is not sure about the exact level of detail.
Inadequate Data
This happens when the healthcare provider fails to provide all the information required to the payers. The result is a claim denial. These errors may be due to employee errors. This can also occur when DME doctors fail to provide accurate diagnostic information.
Report misinterpretation
DME coders rarely code actual medical procedures unless they are given the details of the equipment. It could lead to incorrect interpretations of reports or errors in DME billing and coding.
Outdated Refers
Staff must keep up-to-date with the latest DME medical codes. As the DME coding system evolves, coders need to keep their references up-to-date. Or revenue may be lost if outdated references are not replaced immediately.
Duplicate Billing
In this instance, the DME equipment was billed twice due to human error. This could mean that you need to submit a new claim instead of filing a follow-up claim. These claims can be divided into two types: exact duplicate and suspect duplicate.
Avoiding DME Medical Coding Mistakes
DME medical code errors can prove to be very dangerous, especially if they are repeated. DME healthcare providers, clinics, or other medical centers can be affected by these errors, which can lead to significant financial losses. Below are some of the best tips to avoid DME billing errors.
Use a robust system
DME billing systems that can detect common errors before claims are submitted can greatly reduce the likelihood of errors.
Have a well-trained team
It is crucial to hire skilled people who have been trained to handle all requests. The team must ensure that every claim is unique to avoid duplicate DME billing.
Use Unified Processes
Medical coding teams must follow a consistent process to avoid mistakes like upcoding and unbundling.
Outsourcing can reduce DME billing errors!
Medcare MSO is an expert company that can help you avoid DME billing mistakes.
The best way to reduce errors is to outsource DME medical billing services. This will reduce your workload and errors, so you can focus on your patient. Entrusting your DME billing process will greatly reduce errors, denials, rejections, and other blunders.
