Question

Mrs. Kelly had an appointment to see the doctor for a persistent low- grade fever. During the visit she mentioned that she had twisted her ankle a week or so ago and that it still hurt when she put weight on it. The doctor took -rays and found that there was a stress fracture. He gave her a post-op shoe to wear to provide more support and reduce her pain. When coding this patient’s visithe used fever for the diagnosis code, and he used x-rays and a post-op shoe for the procedure codes. What error did the doctor make when coding?

Answer 1

Q: What error did the doctor make when coding?

A: The doctor committed an error in coding by using incorrect procedure codes which is also one of the most common errors in medical billing. The doctor should have used 'stress fracture' as the diagnosis code and x-rays and a post-op shoe for the procedure codes even though she had come in to consult the doctor for a a persistent low- grade fever this wasn't the cause of the problem but only a symptom or body reaction for the root cause of the problem which was the stress fracture. X-rays and a post-op shoe is the procedure or treatment the doctor performed based on his diagnosis from a billing point of view and a future insurance claim point of view by the patient, Mrs. Kelly.