Advance: Practice Performance Audits
A practice performance audit involves reviewing four general areas: data/entry billing, clinical documentation, coding, and charge capturing; however, many other areas of the practice affect reimbursement. AAPC’s Marsha S. Diamond, CPC, CPC-H, CCS, recently expounded on practice performance audits in an article published by Advance for Health Information Professionals.
“As coders well know, even when ICD-9-CM and CPT codes are assigned correctly for the encounter, the claim may not be properly paid due to a multitude of reasons or failure of processes within the practice,” she says. “The practice performance audit attempts to evaluate where errors/omissions occur, timeliness of practice processes, and inefficiencies within the practice that result in incorrect, delayed, or denial of requests for payment for services.”
Read the full article.
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