Wiki Should / Can Coders Enter Charges ????

[girlsrulekrk@gmail.com]

My Question for the forum is should coders be entering charges or is it the responsibility of the providers, nurses, and other clinical staff to enter their own charges for service?? Where would I be able to find a guideline that tells what the law is for this. My personal thought is that if I the coder enters a providers charge it is not verified by the provider we also have an issue of the providers do not document enough to pick a charge. any help would be greatly appreciated.

 

[CodingKing]

Providers, nurses, and other clinical staff really should stick with their job of treating the patients and documenting the medical record. Coders and billers should be handing the rest. There is no law stating who can handle the rest. There is no law a person has to be credentialed to be a biller or a coder either. In reality its whatever your clinic policy is.

 

[thomas7331]

There are no laws governing this - providers are responsible for accurate claims, but each organization can set up their own process and decide how to use the resources they have to achieve this. Especially in larger organizations, it's just not feasible to have coders review every single charge, so many will just use their coders for auditing, or for complex coding areas where there is higher risk for an error. In areas where the coding is simple, e.g. there are a limited number of codes to choose from or the choices of codes are black and white, the organization may determine that the risk is low and the providers or ancillary staff can enter their own charges with little risk of error.

Organizations that are concerned about compliance and accuracy in coding will conduct periodic audits or reviews of their charges and then provide education and corrective action to target the issues where they occur, but it's not necessary, nor a good use of resources, to have a coder involved in every charge that goes out.