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Reducing Denials With Autonomous Coding | Medical Coding Automation

Written by Kacie Geretz, Director of Growth Enablement | Jul 2, 2025 2:48:00 PM

Key Takeaway: Coding-related denials surged 126% in 2024, costing providers $265 billion annually, with a significant percentage of denials stemming from medical coding-related errors. This article examines the three primary coding-related denial causes and reveals how autonomous medical coding solutions like Nym’s engine can help prevent these errors by ensuring alignment with internal, regulatory, and payer guidelines and drastically improving coding consistency.

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The Escalating Denial Crisis

Common Coding-Related Denial Reasons

Industry Solutions for Denial Prevention

FAQ About Autonomous Medical Coding and Denial Management

Healthcare organizations face mounting pressure to optimize revenue cycle management while managing complex coding requirements and persistent staffing challenges. With the industry experiencing a 30% shortage of medical coders (1), providers need solutions that address both accuracy and efficiency concerns.

Recent benchmark data reveals the severity of this challenge: coding-related denials increased by 126% in 2024, representing one of the largest increases in three years (2). At least 15% of all medical claims in the United States are denied, according to Experian, costing providers $265 billion annually (3). These denials create cascading challenges, including payment delays, increased administrative overhead, and potential revenue loss.

The Escalating Denial Crisis

The 2024 MDaudit Benchmark Report, analyzing data from over 650,000 providers and $8 billion in audited claims, reveals alarming trends: 

  • External audit volume more than doubled in 2024 over 2023 levels
  • At-risk dollars increased fivefold to $11.2 million
  • Medical necessity denials increased 75% for outpatient claims and 140% for inpatient claims
  • Average denied amounts increased across all care settings, with hospital inpatient denials rising by ~200%

These increases expose healthcare organizations to significant cash flow impacts and highlight growing scrutiny from payers seeking to identify and deny improperly coded claims.

Common Coding-Related Denial Reasons

Missing or Incorrect Modifiers

Modifier errors, which refer to inaccuracies or issues with the two-digit codes that specify how, where, or when procedures were performed, lead to significant billing challenges. These mistakes frequently involve:

  • Incorrect modifier application for complex procedures
  • Missing modifiers for patients undergoing multiple simultaneous procedures
  • Specialty-specific modifier requirements that vary by payer

Industry data shows revenue opportunities from correcting modifier errors average $13 for professional billing and $191 for hospital billing (2). These oversights trigger automatic payer rejections, often delaying payment by 30-60 days.

Incomplete Documentation Support

Incomplete documentation creates another major denial category because clinical notes often lack sufficient detail to support assigned codes. Recent audit findings reveal that "diagnosis documented but not billed" represents 58% of professional billing issues and 37% of hospital billing problems (2). This challenge occurs when:

  • Providers focus intensively on patient care without adequate time for comprehensive documentation
  • Clinical complexity isn't fully captured in standard documentation templates
  • Supporting details for medical necessity aren't clearly linked to procedure codes

The revenue impact is substantial: correcting diagnosis undercoding represents an average opportunity of $202 for professional billing and $3,922 for hospital billing (2).

Code Mismatches and Medical Necessity Issues

Code mismatches occur when diagnosis codes don't align with procedures performed, creating medical necessity questions. Insurance companies now use sophisticated technology to automatically flag these inconsistencies, contributing to a 122% increase in commercial payers' requests for information (RFI) denials (2). This results in:

  • Higher denial rates for practices with ongoing coding accuracy issues
  • Increased scrutiny on subsequent claims from the same provider
  • Requirements for additional documentation to support medical necessity
  • Delayed payments while claims undergo manual review processes

Industry Solutions for Denial Prevention

Healthcare organizations have traditionally addressed coding challenges through staff augmentation, outsourced coding services, and Computer-Assisted Coding (CAC) systems. However, with the current 30% coder shortage and high turnover rates, these approaches often prove expensive and unsustainable while still requiring significant human oversight that maintains vulnerability to the coding errors driving current denial increases (1).

The autonomous medical coding industry has emerged as a comprehensive solution, representing a fundamental shift from computer-assisted coding to fully independent code assignment. These solutions process thousands of charts in minutes with industry-standard 95%+ accuracy while operating in the background and sending coded charts directly to billing systems.

Nym's Approach to Denial Reduction

Addressing the specific denial challenges outlined above, Nym's autonomous medical coding engine distinguishes itself through two key mechanisms that help prevent coding-related denials.

Consistent Alignment with All Guidelines: Nym's engine maintains continuous alignment with both external regulatory and payer guidelines (ICD-10, CPT, NCCI, LCD/NCD requirements) and internal health system, hospital, and physician group coding guidelines. This dual compliance ensures every code assignment meets both standard industry requirements and organization-specific coding philosophies, eliminating the guideline misalignment that drives denial increases.

Unwavering Coding Consistency: As an autonomous engine, Nym codes with complete consistency across all encounters, eliminating the human variability that creates coding pattern inconsistencies flagged by payer systems. This consistent application of guidelines prevents the modifier errors, documentation interpretation gaps, and code selection variations that trigger automatic denials and audit scrutiny.

Organizations implementing Nym's engine achieve measurable denial reduction results:

  • A large health system experienced a 97% decrease in radiology professional fee coding-related denial rate, directly countering the industry trend of surging denials through proactive error prevention.

  • Geisinger, a large health system, reduced coding-related denials to less than 0.1% after implementing Nym’s autonomous medical coding solution for emergency medicine. Read the Geisinger case study.

Request a demo to discover how Nym's transparent autonomous medical coding engine can help your organization prevent coding-related denials while simultaneously reducing coding costs, accelerating payment cycles, and increasing revenue capture.

FAQ About Autonomous Medical Coding and Denial Management

What's driving the surge in coding-related denials?

Coding-related denials increased 126% in 2024, primarily due to three factors: missing or incorrect modifiers that trigger automatic payer rejections, incomplete documentation that fails to support assigned codes, and code mismatches where diagnosis codes don't align with procedures performed. These issues are compounded by a 30% medical coder shortage and increased payer scrutiny using sophisticated technology to flag inconsistencies.

How does Nym's engine specifically prevent coding-related denials?

Nym's engine prevents denials through two key mechanisms: consistent alignment with both external regulatory/payer guidelines and internal organizational coding guidelines, ensuring every code meets all requirements; and unwavering coding consistency across all encounters, eliminating human variability that creates the modifier errors, documentation gaps, and code selection variations that trigger denials. Organizations using Nym have achieved results like a 97% decrease in radiology coding-related denials.

How do Nym's audit trail capabilities support the denials appeals process?

Unlike "black box" AI solutions, Nym's engine provides fully transparent audit trails for every code assignment using rules-based CLU technology that enables complete explainability. Every encounter includes supporting documentation, specific guideline references, and step-by-step coding rationale. This comprehensive transparency makes it easier to defend coding decisions during appeals processes and demonstrate compliance with both regulatory and payer requirements when challenging denials. See an audit trail example here.

Sources

  1. Addressing another health care shortage: Medical coders. American Medical Association. Retrieved from https://www.ama-assn.org/about/leadership/addressing-another-health-care-shortage-medical-coders
  2. (2024). 2024 MDaudit Annual Benchmark Report. MDaudit. Retrieved from https://icd10monitor.medlearn.com/coding-related-denials-surge-in-newly-released-benchmark-study/
  3. (4 October 2024). Healthcare claim denial statistics: State of Claims Report 2024. Experian. Retrieved June 12, 2025, from https://www.experian.com/blogs/healthcare/healthcare-claim-denials-statistics-state-of-claims-report/