What could be a consequence of failing to adhere to NCCI edits during coding?

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Failing to adhere to National Correct Coding Initiative (NCCI) edits during coding can lead to increased audit risks. NCCI edits are designed to prevent improper coding that may lead to inappropriate reimbursement in healthcare services. When coders do not follow these guidelines, it increases the likelihood of submitting claims that could be flagged for audit, leading to potential financial repercussions for healthcare providers. Audits may result in claims being denied, the need for refunds, or even penalties for non-compliance. Thus, adherence to NCCI edits is crucial for maintaining compliance and minimizing the risk of audits.

While the other options suggest positive outcomes, they do not align with the implications of ignoring coding rules. Enhanced service delivery, improved patient outcomes, and lowered insurance premiums are not likely results of non-compliance with coding standards. Instead, proper coding practices, including adherence to NCCI edits, support financial integrity and promote better service delivery in a compliant manner.

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