Medical Auditing Practice Exam

Which analysis method is best for identifying patterns of undercoding and upcoding among physicians in similar practices?

1. Trend analysis

2. Aggregate analysis

3. Correlation analysis

4. Statistical sampling

The correct answer is: Aggregate analysis

Aggregate analysis is particularly effective for identifying patterns of undercoding and upcoding among physicians in similar practices because it allows auditors to compile and summarize data from multiple sources. This method provides a comprehensive overview of coding behaviors across different practitioners, which can reveal trends or inconsistencies in how services are reported. By evaluating the combined data, auditors can identify variations in coding practices, such as consistent discrepancies in reported services relative to what is typically expected for similar cases or specialties. This broad analysis can facilitate comparisons among peers and highlight areas where coding practices may not align with established standards. In contrast, trend analysis focuses on changes over time rather than direct comparisons among peers, correlation analysis looks for relationships between variables without directly addressing coding practices, and statistical sampling is used to draw conclusions from a subset of data but may not provide the comprehensive insights available through aggregate analysis.