Checking It Twice: A Holiday Coding Accuracy Checklist for Clean Claims

Accuracy is the foundation of quality coding. This holiday-themed checklist walks coders through practical steps to avoid common errors, strengthen documentation alignment, and incor updates. From sequencing and guideline refreshers to documentation prompts and final quality checks, this guide helps you maintain clean, compliant claims—no matter how hectic the season gets.

Even during the busiest season of the year, accuracy matters. Before getting wrapped up in year-end coding, take a moment to review the essentials and ensure everything on your list checks out.

Why “Checking It Twice” Matters

Santa isn’t the only one who benefits from double-checking his list. Coders face year-end coding challenges, preparation for annual updates and reduced work hours due to holiday time off —both of which can increase the risk of overlooked details and avoidable errors.

Taking a few minutes to slow down, verify documentation, and apply official guidelines ensures accuracy, compliance, and smoother downstream outcomes for your team.

Your Holiday Coding Accuracy Checklist

Use this checklist as a quick reference to keep code selection and sequencing aligned with best practices.

Review the Documentation with a Critical Eye

Before assigning codes, confirm the documentation includes:

• Clear diagnoses with supporting clinical indicators
• Specific details such as laterality, acuity, and type
• Procedure descriptions that include intent, approach, and device details
• Clarification of complications versus expected outcomes
• Any addenda or late entries providers may have added

Documentation gaps are one of the biggest drivers of denials and queries—making this the first place worth reviewing twice.

Confirm Guideline Requirements

Even seasoned coders can accidentally skip guidelines, especially when cases feel familiar. Revisit:

• Chapter-specific rules
• Sequencing requirements
• Combination code instructions
• Excludes1 and Excludes2 notes
• Root operation definitions for ICD-10-PCS
• CPT bundling, add-on codes, and modifier rules

A quick guideline check can prevent some of the most common errors seen during reviews.

Validate Proper Sequencing

Correct sequencing affects DRG assignment, and payment accuracy. Double-check:

• Principal diagnosis is appropriately supported
• Secondary conditions meet reporting criteria
• Complications are clearly documented and clinically validated
• External cause and place of occurrence codes are used only when required

A sequencing review is one of the fastest ways to strengthen audit outcomes.

Verify the Use of Updated Codes

With new fiscal year updates in place, make sure you’re assigning:

• Current ICD-10-CM and ICD-10-PCS codes
• Accurate CPT and HCPCS codes
• Deleted or revised codes not accidentally included
• Updated DRG mappings where applicable

A quick look at yearly updates prevents outdated code usage and reduces claim rework.

Perform a Final Quality Check

Before closing the record, ask yourself:

• Does the documentation fully support the codes?
• Are all seventh characters correctly applied?
• Are any modifiers missing or unnecessary?
• Does the coding reflect the entire encounter?
• Would the record pass an internal or external review?

This “final once-over” is the coder’s equivalent of tying the bow on a perfectly wrapped package.

Set Yourself Up for a Strong New Year

Accuracy today means fewer denials, smoother reviews, and better outcomes for providers and patients tomorrow. Incorporating a consistent “check it twice” habit—especially during busy seasons—helps coders stay confident, compliant, and ready for whatever the new year brings.

If your team needs help preparing for annual code updates, strengthening audit outcomes, or accessing on-demand education, HIAlearn offers CEU courses designed to keep coders informed and supported all year long.

The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.