Wiki Coding corrections/compliance

Lorijo

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Chesilhurst, NJ
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Hi all,
I have a question regarding coding corrections. I work for a hospital where I auditi/correct the professional claims. The hospital is telling me if a related invoice is paid and the coding is incorrect, we don't need to correct the claim. We only need to correct the "unpaid" claims that are part of our work inventory. To me, as a coder the appropriate correction would be to correct all claims related to the claim in our inventory so the entire hospital stay is coded/billed correctly. I don't feel comfortable only fixing the denied claim and not the entire stay which is coded incorrectly. Thoughts? Am I thinking about this too much? Any advise will be appreciated. Thank you!
 
I would be uncomfortable with this also. If you become aware that a claim that has already been paid was coded and billed incorrectly, then I would consider it an obligation to submit a corrected claim to the payer. This would be especially true if the correction could potentially cause the claim to pay differently. I would also ask myself, if the hospital does not want you to correct any claims that have already been paid, then why are you they even having you spend your time auditing these claims in the first place?
 
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