Jul 6th, 2017
Charlotte-Mecklenburg Hospital Authority is paying the federal government $6.5 million to resolve allegations the company violated the False Claims Act, up-coding claims for urine drug tests. The group, owned by Carolina HealthCare System, submitted high complexity evaluation and management (E/M) codes for urine drug tests, which Medicare considers moderate complexity. The government alleged that t...
When a registered nurse bills under the nurse practitioner, you are liable for overpayments.   By Michael D. Miscoe, JD, CPC, CASCC, CUC, CCPC, CPCO, CPMA Q: I am reaching out in the hopes of receiving guidance to a question posed by one of my physicians. This particular physician works offsite from the office, usually in the ...
Aug 1st, 2011
As a coder, you are liable for more than you may think. By David M. Vaughn, JD, CPC In the federal criminal arena, you can be liable both for performing an illegal act and for aiding and abetting a criminal act performed by superiors. You also may be liable for helping superiors to avoid getting ...
Jun 1st, 2010
By Stacy N. Harper, JD, MHSA, CPC HIPAA Privacy Rules grant individuals the right to request additional restrictions on the uses and disclosures of their protected health information (PHI). Until Feb. 17, it was entirely at the discretion of the health care provider whether to grant this request. This is no longer the case. The ...
In Billing
Feb 1st, 2010
By Michael Miscoe Question: For my specialists who have many subsequent visits, the doctor provides specific detail (i.e., the degree of burn, stage of ulcer, infecting organism, etc.), but only on the initial visit. Must a claim be coded per its own dictation only? That is, must the dictated record stand on its own, separate ...