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Wiki Downcoding - As a coder

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Lynda Wetter

Lynda Wetter

True Blue
Local Chapter Officer
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Glen Allen, VA
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As a coder if I am asked to downcode a record to give the patient a break that is fraud, correct?
If I understand correctly. We would bill the correct code and if the patient cannot pay the balance we can then offer a credit/adjustment as a courtesy, correct?
 
Down coding is just as bad as upcoding. If you are a Medicare provider, they can 'drop' you as a par provider for this. You need to code the service provided as it is documented. Does your office have a policy for charity care in place?
 
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