Certified Risk Adjustment Coder (CRC)

Which action is NOT recommended if discrepancies are found during retrospective chart audits?

1. A. Submit additional codes.

2. B. Delete unsupported codes from the data submitted to CMS.

3. C. Ignore discrepancies.

4. D. Compare claims to the documentation.

The correct answer is: C. Ignore discrepancies.

In the context of retrospective chart audits, identifying discrepancies is essential for maintaining accuracy in coding and reporting. Not addressing these discrepancies can lead to significant issues, including incorrect reimbursement and potentially contributing to compliance problems. Ignoring discrepancies is not a recommended action because it undermines the integrity of the coding process. Instead, discrepancies should be investigated thoroughly to ensure that the data accurately reflects the patient's medical conditions and the services provided. Recognizing and addressing these discrepancies is vital for compliance, financial accuracy, and quality of care. The other options involve proactive measures to rectify or examine the issues identified during the audits. Submitting additional codes where justified supports accurate reporting, deleting unsupported codes helps maintain the integrity of the data submitted to CMS, and comparing claims to documentation ensures that coding aligns with the clinical record. Each of these actions contributes to a more reliable and compliant coding process.