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Question re:billing proc when the coder is the pt?

  1. Default Question re:billing proc when the coder is the pt?
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    I am just curious....does anyone know what the correct thing to do ethically speaking if a patient has a procedure at an ASC and that patient happens to be a coder who works at that facility.....would there be anything wrong with that person coding/and or billing their own procedure?

  2. Default Reply
    I know of no coding rules that say a coder can't bill for their own services. I have processed my own office visits at my office without any repercussion. As long as no fraud is involved to the coder's insurance company and the ASC doesn't have an internal rule against it than all should be fine.

  3. Default
    This happened to me, they wouldn't allow me to see my own record. Someone else coded it.

  4. #4
    It could be considered a conflict of interest. I will not even code an encounter of a patient I know outside of work, because I feel that patient has a right to privacy.

  5. #5
    Milwaukee WI
    Default Best Practice
    I would think that best practice would be to NOT allow the coder to code his/her own record (or that of his/her family).

    This is not to say that you are not ethical or would even consider not coding this accurately. But it's important to avoid even the appearance of impropriety.

    F Tessa Bartels, CPC, CEMC

  6. #6
    Default billing procedure
    We have had this come up several times here at our facility. Each time, the person/persons would have someone else code their visit or the visit of someone they knew or were related too. I don't know of any rules, except our own. This way, there would never be any question as to whether it was done inappropriately.

  7. #7
    It would best practice NOT to allow the coder to code their own service(s) as this may be considered a conflict of interest and may be a red flag for fraud.

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