Which item is NOT a CERT error category?

• A. No documentation
• B. Incorrect coding
• C. Timeliness of submission
• D. Medical Necessity

Answer: (C)

Focusing on the kinds of issues CERT is designed to flag helps you see why this item isn’t a CERT error category. CERT reviews look at whether the documentation supports the billed service, whether the coding matches what’s documented, and whether the service is medically necessary. Those areas—No documentation or insufficient documentation, Incorrect coding, and lack of Medical Necessity—are the typical CERT error categories because they directly affect whether payment is appropriate based on the medical record and coding.

Timeliness of submission, while important for payer rules and payment timing, isn’t scored as a CERT error category. It relates to when a claim is filed rather than whether the service was documented, coded correctly, or medically necessary. So the item describing timeliness of submission is not part of CERT’s error categories.