the impact of the clinical miscoding on inpatient reimbursement

Background: the purpose of this study was to investigate the rate of coding errors and its effect on the amount of correct reimbursement to patients. methods: this descriptive and cross-sectional study was performed in 2018. research resources were records in compensation units in medical documents center of social security organization. a total of 546 records were reviewed of which, 118 records met the research criteria and were selected through census method. instrument for data collection was a checklist composed of six parts. data were collected by compensation unit coders. results: in total, 118 records met the inclusion criteria. the highest rate of documentation error was related to unconfirmed errors with 106 items and a coefficient of 3845.44. the cost issued to patients based on tariff codes with a coefficient of 9696.4 was estimated as 3684632000 rials, which only 2416154000 rials was reimbursed to the patients with the coefficient of 6358.3.conclusion: since coding of diagnostic measures had a high percentage of errors, and the recording of services was not accepted, some proper policies must be adopted to reduce procedure miscoding.