Wiki Software Question

coder21

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If you use a software that codes the chart but tells the provider that you have coded a level 99203 but if you add x y and z you could code a 99204 isn't this leading an a compliance issue? Thank you
 
Hi coder21,
Yes, this can lead to a compliance issue with the organization if the provider adds anything that is not true to the actual services rendered.

One thing to consider when using EHR systems is that some vendors are creating and maintaining the applications to "help" maximize revenue for the clients and aren't aware of current guidelines that the medical professionals adhere to. In cases like these the clients will need to be aware of these functions that are in the applications and if possible report to the vendors to have these functions disabled. Or better yet continue to shop around for a credible application that is run by credible professionals with a background in medical and revenue cycle.

Most of these EHR/Practice Management Application vendors have backgrounds in marketing, computer programming, etc but have little to no idea about how the clinics and hospitals operate and the current guidelines that are in effect.

Best thing to do is to be aware of these functions and communicate to everyone.

Jeff
 
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