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What is a common consequence of not adhering to coding guidelines?

Increased patient trust

Improved healthcare delivery

Inaccurate billing and potential audits

The consequence of not adhering to coding guidelines leads to inaccurate billing and potential audits. Coding guidelines are established to ensure that healthcare providers accurately capture the services they provide, which directly affects billing. When codes are improperly applied or when documentation does not support the codes used, it can result in claims being denied or underpaid. This inconsistency can trigger audits from insurance companies or regulatory bodies, which scrutinize the coding practices and billing processes of healthcare providers. As a result, the organization may face financial repercussions, reputational damage, and legal challenges, all stemming from the failure to follow proper coding protocols. Collectively, these factors can heavily hinder a healthcare practice's financial health and operational integrity.

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