Certified Outpatient Coder (COC) Practice Exam

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Which of the following is not generally included in a coding audit?

Documentation review

Billing practice evaluation

Insurance policy verification

In a coding audit, the focus is primarily on assessing the accuracy and integrity of the medical coding process. This includes examining the documentation to ensure that it supports the codes chosen, evaluating billing practices to verify that they comply with coding standards and regulations, and conducting a clinical coding assessment to determine whether the right codes were assigned based on the clinical information provided. Insurance policy verification, however, typically falls outside the scope of a coding audit. This process involves confirming the terms, coverage, and benefits associated with a patient's insurance plan, which is not directly tied to the coding or billing processes the audit aims to evaluate. Therefore, while documentation, billing practices, and clinical coding are integral components of an audit, insurance policy verification does not align with the standard purpose and methodologies of coding audits.

Clinical coding assessment

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