Medical Coding Mistakes That Can Hurt Your Audit Results (And How to Avoid Them)
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Even experienced coders can fall into habits that lead to costly errors. Some mistakes might only cause a small claim delay, while others can raise compliance flags or trigger audits. Whether you’re new to the field or building on years of experience, being aware of common pitfalls is the first step to avoiding them.
Skipping the Guidelines
- The mistake: Jumping straight to the codes without reading the chapter/section-specific guidelines.
- Why it matters: CPT and ICD-10 guidelines often include crucial details that change how a code should be applied. Ignoring them can lead to incorrect or incomplete code assignments, sequencing errors, or missing secondary codes.
- How to avoid it: Take time to review the official guidelines before coding a specialty or complex case. Refresh your knowledge regularly—especially after annual updates.
Minimizing Provider Documentation
- The mistake: Assuming the intent of the provider or finalizing coding from incomplete or vague documentation.
- Why it matters: Incomplete, unclear, or missing documentation can affect both coding accuracy and compliance. Making assumptions can lead to upcoding or undercoding.
- How to avoid it: Query the provider when documentation lacks clarity. Stay current on query best practices and documentation improvement strategies.
Ignoring Code Updates
- The mistake: Using outdated codes or failing to use new ones released each fiscal year.
- Why it matters: Code sets are updated annually, and using incorrect codes can cause denials or compliance issues.
- How to avoid it: Set reminders to review ICD-10-CM/PCS, CPT, IPPS and HOPPS updates each year. Continuing education is key—especially in a field that evolves so quickly.
Rushing Through Code Selection
- The mistake: Prioritizing speed over accuracy.
- Why it matters: While productivity is important, accuracy drives compliance, reimbursement, and trust. Even minor errors can add up to major issues.
- How to avoid it: Develop a balanced workflow—double-check your work before submission and maintain productivity through consistent practices and familiarity with common code sets.
Neglecting Continuing Education
- The mistake: Letting CEUs and training slide.
- Why it matters: Coding standards and payer rules are constantly evolving. Falling behind on education can make you less competitive and limit career advancement.
- How to avoid it: Make learning part of your routine. Enroll in courses that expand your coding range, strengthen your guideline knowledge, and earn CEUs toward maintaining a credential.
Take Control of Your Career Growth
Mistakes happen—but consistent learning helps prevent them and builds confidence in your work. Whether you’re refining your inpatient coding accuracy, learning new outpatient procedures, or catching up on this year’s updates, professional growth starts with staying informed.
Explore 200+ courses on HIAlearn to sharpen your skills, stay compliant, and advance your coding career—anytime, anywhere.
Frequently Asked Questions
Q: What are the most common medical coding mistakes during audits?
Q: How can coders reduce errors that trigger audits?
Q: Why is continuing education so important for coding accuracy?
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
The information contained in this blog post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
