Key Takeaways
- Denial prevention improves when causes are segmented by reason, process point, and owner.
- Late-charge and CDM alignment controls reduce repeat outpatient billing defects.
- Corrections should preserve traceable reason/source/action records for compliance defense.
Last updated: February 2026
From coding errors to control design
Top-performing outpatient coding teams convert findings into controls:
- Build denial reason taxonomy with accountable owners.
- Reconcile source systems to final claim output each cycle.
- Require correction notes that document what changed and why.
That approach improves first-pass yield and audit defensibility.
Test Your Knowledge
Which corrective approach best supports outpatient compliance defensibility?
A
B
C
D
Congratulations!
You've completed this section
Continue exploring other exams