30 irregularly priced items!

Our coding experts recently reviewed a claim and found 30 irregularly priced items. This occurs when different prices are applied to the same quantity of an item ad different points on a claim. For example, the claim under review listed CEFEPIME PER 500 MG at $106 which is the normal pricing and also at $145, resulting in the irregular price coding.  These kinds of errors can add up over the course of just a single episode of care and are especially common with medications. In this instance the reductions totaled $28,071.50 in reductions due to irregular pricing alone.