What does coding compliance refer to?

Coding compliance is primarily concerned with adhering to established regulations, guidelines, and standards in coding practices. This involves ensuring that all coding is accurate, complete, and consistent with the rules set forth by organizations such as the Centers for Medicare & Medicaid Services (CMS) and the American Health Information Management Association (AHIMA).

When coding is compliant, it reduces the risk of fraud and abuse, ensures proper reimbursement, and maintains the integrity of medical records. It also helps healthcare providers avoid penalties associated with incorrect billing practices. Understanding coding compliance is essential for healthcare professionals involved in coding and billing processes, as it impacts the financial health of healthcare institutions and the quality of patient care.