Law & Ethics
I completely concur with Lorene. Situations like the one you are describing requires coders to transition there daily obligation to acting part lawyer. Behind every ethical conducted health facility there is a coder acting part lawyer, oracle, analyst, anatomist, physiologist, biller, coder; etc. (Quoted from writer Brad Erickson AAPC CODING edge magazine)
Don't be afraid to speak your voice--even when it shakes. When providers start breaking rules under one plan, most likely it will happen in the future to another;hence, opening themselfs and you to fraudulent charges. PUT the provider IN CHECK. Remember all MDs, DOs and DCs are scientist, and although seem adriot professionals in the medicinal business aspect, they could be real inept to the healthcare legal process; that is when a well educated coder in healthcare policy comes into play.
I would follow-up with what member7 says under the CMS website. Or contact the NAB of the AAPC.
Chad Malek, CPC, CCA