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Coding regulations

  1. Default Coding regulations
    Medical Coding Books
    I need documentation showing that a physician is not required to review every code selected before it is billed. Someone told our physicians that they must review everything we do before it is billed.

  2. #2
    Swainsboro/Statesboro, GA
    Default No regulation
    I don't think you will find what you are looking for. Providers are responsible for everything billed under their name/number, regardless of whether or not they personally review every service or item charged/billed.

    Being responsible does not necessarily mean the provider has to review every code, but there should be appropriate staff members in place to give the provider confidence in all charging and billing. Periodic audits of the practice should be conducted to verify these processes are in place and are working as "assumed".
    Freda Brinson, CPC, COC, CEMC
    AAPC Swainsboro/Statesboro Chapter
    2017/2018 Secretary/Treasurer
    2016 Education Officer
    2014/2015 President
    Past President - 2012, 2008; Past Vice President - 2013, Past Education Officer - 2009 of Savannah, GA Chapter
    Past Member AAPCCA Board of Directors (2009-2012)

  3. #3
    Columbia, MO
    I agree I have never observed in writing where it states this, however the coder needs to review all documentation before assignment of codes.

    Debra A. Mitchell, MSPH, CPC-H

  4. Question Documentation for coding
    So, that brings me to a question I have been trying to get an answer to for weeks. Is it appropriate to get a DX from documentation not pertaining
    to the date of service that you are coding? I was told to look in the chart at past visits for codes, but I'm not convinced that that's correct. Do you know
    where I might find guidelines about that?

  5. #5
    Columbia, MO
    You are never allowed to refer to previous documentation for dx that are not documented in the current encounter. I believe that Coding Clinics have covered this issue many times.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Thanks, thats what I thought.

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