Optimal coding

Submission of a patient’s bill with diagnosis and operation coding which will qualify for the highest reimbursement possible, yet avoid any suggestion to the payer’s audit system that an attempt is being made to obtain unjustified reimbursement, i.e., to avoid interpretation of the bill as “over-coded”. Computer systems which are intended to achieve optimal coding are commercially available to health care providers. Compare to under-coding and over-coding.


 


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