hardScenarioCase StudySeniorStaffLead
Your coded case mix has drifted upwards over two quarters. How do you tell better documentation from upcoding?
6 min readUpdated 2026-08-15
Answer
Short answer
Only the record can settle it. Rule out mix, population and grouper changes, then run a blind re-code of a stratified sample, report disagreement rate and direction, attribute each disagreement to coder, documentation, template or incentive, and fix the cause rather than the codes.
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Likely follow-ups
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