5 Best Practices For Medical Coding And Billing For An Efficient Service Delivery

When using a medical coding and billing software package, it’s essential to keep these best practices in mind to ensure you’re maximizing the benefits of your technology and saving money along the way! Coding and billing best practices ensure that clients receive the services they pay for, while providers get paid fairly and appropriately for their work. Here are some tips from medical coding professionals on ensuring your coding and billing practices follow industry standards and are as efficient as possible. Here are our top 5 suggestions.

Staying Up To Date With Coding Guidelines

There’s no doubt that medical coding is a competitive field. There are countless new technologies, billing guidelines, and software updates rolling out every year. While staying up-to-date with these changes may seem daunting, it’s essential to keep up with them so you can serve better and remain competitive in your field. A medical coder needs to learn how to be proactive about coding and billing best practices—otherwise, you risk underbilling or going above your limit.

Staying up to date with coding guidelines helps you execute your mandate professionally and, at the same time, build a successful career. You can take advantage of some professional resources offered by organizations like AAPC or even your other professionals in medical coding and billing you can trust.

Submitting Accurate Claims

It happens that insurance companies may deny your medical bills. If an insurance company denies your claim, you may not receive the payment at all. It’s often because of an incorrect diagnosis code or improperly reported office procedure codes—this is why it’s important to follow standardized coding rules when submitting claims. The more accurate your billing practices are, the better your reimbursement.

Most practices don’t realize that they can challenge any denials, but often they don’t do so until patients begin calling and making threats. Best medical coding and billing practices will help you avoid huge sums in unpaid receivables down the road. Technology upgrades can lead to greater efficiency in managing your practice and reduce time spent on tedious tasks. Automation helps ensure accuracy in coding and billing!

Avoiding Upcoding to Increase Revenue

Upcoding is the malpractice of increasing a claim’s dollar value to maximize reimbursement. For example, if your visit for an ankle sprain bill is $200, malpractice may choose to upcode that service to an ankle fracture, which would add another $100 to your fee. Although it may seem tempting from a financial standpoint, upcoding has negative repercussions down the road.

First off, it hurts patient satisfaction; no one likes feeling as though they’ve been misled or overcharged. Second, medical review committees will see through your false claims and find other ways to lower payment in future years. They will even look into current kickback dollars owed if they discover inappropriate upcoding in their audits, which are more common than you may think. As such, it’s essential to refrain from these malpractices by all means.

Encouraging Patients to Make A Follow-Up Appointment

An excellent way to prevent medical expenses from spiraling out of control is to develop a solid follow-up protocol. Encourage patients to schedule their follow-up appointments and help them figure out what tests they will need when they get there. The more control you can give your patients over their medical bills, the more likely they will keep them in check. An excellent medical and billing system will help a medical coder/biller schedule appointments between physicians and their patients appropriately.

Focusing On Inpatient Care

Inpatient stays are more likely to be reimbursed by insurance companies, so if you plan to focus on inpatient care, it’s essential to have billing codes for each. CPT codes classify medical procedures, while ICD-10 codes classify symptoms or diseases. Patients pay an insurance company a copayment or coinsurance when they receive inpatient care; these fees will help cover your costs while increasing your reimbursement.

Medical coding and billing professionals also increase their chances of health facilities receiving payments for services when they clearly define CPT and ICD-10 codes. If you choose to take both kinds of patients—inpatients and outpatients—it’s worth looking into outpatient coding resources; there is overlap between outpatient and inpatient coding systems, but there are also crucial differences.


The best medical coding and billing practices keep your office on time, on budget, and maximize your reimbursements. Best practices for medical coding and billing professionals are an important goal because it allows you to expand your practice more quickly than you otherwise would be able to do. Additionally, it leaves you with more time for you to take care of patients so that your practice can grow in size as well as in scope. For the best medical coding and billing practices, you can contact professional medical coding and billing experts in your area.