Canadian Health Information Management Association Practice Exam

In coding audits, what is the primary objective?

1. Increase revenue

2. Ensure compliance

3. Reduce coding errors

4. Enhance staff training

The correct answer is: Ensure compliance

In coding audits, the primary objective is to ensure compliance with coding standards and regulations. This involves reviewing and verifying that the codes assigned to diagnoses and procedures are accurate and follow the established guidelines set by various regulatory bodies and payers. Compliance is crucial as it helps maintain the integrity of the healthcare organization and ensures that claims submitted for reimbursement are done correctly according to the legal and ethical standards. While increasing revenue, reducing coding errors, and enhancing staff training are all important elements that may result from conducting coding audits, they are secondary to the fundamental goal of ensuring compliance. Compliance prevents legal issues and penalties that may arise from incorrect coding practices, promoting overall accountability and quality in health information management.