Wiki Who is ultimately responsible for Correct Coding

[Reenie98]

I attended a seminar a couple of years ago; where the speaker cautioned us on changes to definitions in the laws. They specified; these changes allow the OIG to look at BOTH an organization AND the coders involved for fraudulent claims. I have unfortunately misplaced the notes for this. The speaker cautioned us specifically that Correspondence telling coders to code a certain way from a manager or Client; no longer protected them from liability; that we are INDIVIDUALLY responsible for coding despite any direction given. I am looking for something that says this in black and white; can anyone point me in the right direction.

I have been looking today; I am finding lots of cases with individuals sited; but nothing where the individual can prove they were told to act in that manner; and maybe that in itself is the answer; I don't know.

 

[mitchellde]

I remember an AAPC article that was written by an attorney many years ago where he stated that coders are liable for all codes they submit. I don't know if someone at the AAPC can tract this down for you or not in was in an old Coding Edge.

 

[csperoni]

This AAPC article cites several suits as well as HIPAA regulations. The general idea is that any knowing party is liable, regardless of whether or not you were instructed to do so.
https://www.aapc.com/blog/23896-criminal-and-civil-liability-of-coders/

 

[Reenie98]

This AAPC article cites several suits as well as HIPAA regulations. The general idea is that any knowing party is liable, regardless of whether or not you were instructed to do so.
https://www.aapc.com/blog/23896-criminal-and-civil-liability-of-coders/

Thank you so much!!!!!