Coding 2
Concurrent coding
The review of records and/or use of encounter forms and chargemasters to assign codes during an impatient stay (e.g., hospital) or an outpatient encounter (e.g. hospital outpatient visit for laboratory testing or X-rays, physician office visit).
Encounter forms
Are used to record encounter data about office procedures and services provided to patients.
Overcoding
Reporting codes for signs and symptoms in addition to the established diagnosis code.
Upcoding
Reporting codes that are not supported by documentation in the patient record for the purpose of increasing reimbursement.
Unbundling
Reporting multiple codes to increase reimbursement when a single combination code should be reported
Jamming
Routinely assigning an unspecified ICD-9-CM or ICD-10-CM disease code instead of reviewing the coding manual to select the appropriate code number
Downcoding
Routinely assigning lower-level CPT codes as a conveience instead of reviewing patient record documentation and the coding manual to determine the proper code to be reported.
Chargemasters
contain a computer-generated list of procedures, services, and supplies and corresponding revenue codes along with charges for each.