Psychiatry Coding & Reimbursement Alert
Note That Provider is Responsible Irrespective of Who Chooses E/M
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Question: One of our psychiatrists allows his medical assistant to choose his E/M codes. The assistant is not a certified coder and always picks the highest E/M code possible. Is there anything in writing stating that only a certified coder or physician can choose the codes?
Pennsylvania Subscriber
Answer: You won’t find any written guidelines stating that a physician or certified coder must choose procedure codes. Your psychiatrist can delegate that responsibility to another person, but he needs to understand that doing so does not release him from liability related to the other person’s actions. Your clinician is ultimately responsible for services reported under his name and NPI, regardless of who selects the codes.
Suggestion: Print out some bell curves on appropriate E/M code levels to show to your psychiatrist and his medical assistant. Discuss the possibility of increasing your chances of an audit because of all the high-level codes. Also provide education helping the medical assistant distinguish between the different code levels, so his choices will be more in line with the services provided.
Psychiatry Coding & Reimbursement Alert
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Note That Provider is Responsible Irrespective of Who Chooses E/M
Question: One of our psychiatrists allows his medical assistant to choose his E/M codes. The [...]