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Thread: Unethical Coding

  1. #1

    Default Unethical Coding

    AAPC: Back to School
    I have a question that I hope someone will be able to help with. I have contacted the AAPC and did email someone local, but got very little response...basically..."I'm not sure, let me forward your message on" kinda response, which was very discouraging.
    I did work (until yesterday) for a 3 female OB GYN group. One of the docs was new to the practice and did not care for me, so she made my life a living hell! She was not used to physician education (as far as coding) and made it very clear that her biller was responsible for coding. She would give me a piece of scrap piece of paper with a pt's name, the hospital, date and what procedure she did. Or that she made rounds, not telling me the pertainent information: like diagnosis, in/out patient, level of E/M, ect.....She said that was my job as a CPC to know which codes to use. I understand that for some situations, but am I wrong to not code her E/M at the hospital? I have no access to hospital chart notes. I truely feel like I would be pulling a code from thin air.
    I finally quit my job. I feel that my values and principals were being compromised along with my certification. I feel like I was ask to do unethical coding.
    Am I wrong. Is it my job as a coder to know what code to use? Remember, I'm not talking about minor surgeries.
    One of the other docs also gave me a scrap piece of paper with name, date, spon. vag. delivery. It was the end of the month and I do not get delivery reports, so I entered the charge as is. Normal enough. Except when the OP report came across because it was actually a complicated c/s. They even give me the wrong patients names. Can you imagine what's documented in the patients chart. That is scary to me.
    I know this is long, but I hope someone takes the time to read it. I am very good at what I do, but have felt very incompetent lately.
    Thank you.

  2. #2


    i AM SO SORRY that happened to you. Doctors can be such jerks sometimes. From the day they enter medical school, they act entitled. They probably dont realize what an asset a smart & ethical coder can be. You have to CYA and code what you know to be true. When and if you are ever audited...it's you on the line. I dont know about you but i dont think i would like prison food!! ...Keep your chin up and know this happened so you can be one step closer to a more happier healthier career. This was not the job for you but sometimes you have to shoved out the door to continue on your journey. ..I lost my "Dream Job" when i became pregnant. I was a practice manager of a very large Physician practice. 6 docs, Pa, NPs, 5 clinics and 50 employees. I worked over 60 hrs a week...when i asked to go to 4 days a week they said no. No sorrys, no thank yous..nothing honey..so i left and cried for a week...but i am in such a BETTER position right now.. i have my little girl, a great husband, and only work 2 days a week. I never would have left that job on my own....i needed a push. So, channel all your negative feelings and direct them into finding YOUR dream job!! It doesn't matter if anyone else thinks what happened was right or wrong...YOU know it was wrong..and you did what you needed to do. HOw proud of yourself you must be for doing the right thing!!

  3. #3

    Lightbulb Unethical coding

    Oh my gosh...... THANK YOU SO VERY MUCH. You are so right. There is the better position out there for me, waiting. May you and your family have a safe and happy holiday

  4. #4

    Smile I am sorry

    I am sorry you had to deal with a doctor like that but keep your head up. I was curious though because you stated you didn't have access to the hospital charting. I am the supervisor of a medical record department in a small hospital and every thing that a doctor dictates is copied to their office for coding, H&P, DS, OP Notes, etc.. In some instances, we will copy the physician's progress notes for their billing department. As a hopefully soon to be CPC, i never code anything without the documentation so you are good on that respect. Keep the faith. something will turn up even better than before.

  5. #5
    Join Date
    Apr 2007
    north seattle wa


    I also left my last job because of what I thought was shady coding practices coming from my boss. Now I am in the greatest job I have ever had as a coder. The mangement is incredibly supportive and we all work as a team from the receptionists to the the billers to the docs. We have "discussions" but everyone listens which is great.
    Keep your chin up, when you are doing what is right it has a way of working out. I got my job through the coding edge magazine we get so keep your eyes open. Good luck.

  6. #6
    Join Date
    Apr 2007
    north seattle wa


    Where are you located? Maybe one of us know of something in your area.

  7. #7
    Join Date
    Apr 2007
    Cactus Wren

    Default Ethics

    You did the right thing! Where was the Administrator?

  8. #8
    Join Date
    Apr 2007
    Salt Lake City

    Default well

    Well, you have the moral authroity to 'nark' on them to the AMA if what you feel is unethical. Improper documentation, improper billing techniques, etc.... Maybe a little kick in the hiney is what they need to straighten up their act. Being a Certified Coder you have that moral obligation to fess up if you feel something is wrong and unethical. It can all be annonymus. (Hopefully I spelled those long words right)
    codermcdreamy CPC, CPC-H

  9. #9

    Default Unethical coding

    I just want everyone to know how much I appreciate their response. This has been very therapeutic for me.
    Have a safe and successful holiday season

  10. #10

    Thumbs up

    Just want to say please don't let that experience kill your joy for this job! You did the correct thing, and always remember, if its not documented, it didn't happen!

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