Wiki billing/coding question

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alices

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I hope someone will answer this for me. I am a certified coder and work with all certified coders, I was given a project to train remote coders to code our facility side (ER claims) i was also told not to check there coding on the profee side, now my dilema is that I have to look at the chart in order to train them i have come across them coding the profee side to high, in that they are given them 99284 when in the hpi it only has 2 to 3 elements I have already told my manager about them and there dx's and was told again i am not to check any of there work except just to check the facility level to make sure they are correct. I asked the other coders and told them that i wanted to go and talk to my manager about it because for me i was always told that if i know that a claim is wrong and i let it go out like that then i am just as responsible, is that right? We don't do the billing we code the levels for both sides then we code the dx's and procedures.. so i need some guidance here on this, would I get into trouble if I just let the chg slips go to the billing svc with whatever the remote coders do? Where can I find information on legalities of billing..I am sorry for such a long question but I really need some help on this..thank you alice
 
You said you have brought this to your manager's attention already and were told to stick to the project you were given.

If you take it to the manager again, you might express you are concerned that if an audit picks up on these coding errors it would be bad for the organization as a whole. You could also take a copy of the AAPC Code of Ethics with you so you can show why you are so concerned about this personally as well.

Just be careful about stepping into an area you have specifically been told to stay out of. Hopefully this is audited by someone else, which may be why you have been told to stick to the facility side. Hpi can be tricky especially in an ER note.

Good luck!
 
Thank you for answering, I did bring it to her attention again and she called the ladies in question and just told them about the hpi, their QA person said that she tried to catch all of them but obviously didn't and she would keep a better watch, the problem with all of this is that the QA person wasn't coding the charges right herself, but I did what I could, and hopefully I wont be held accountable for their mistakes..thanks again for the help..alice
 
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