AAPC - Back to school
Results 1 to 6 of 6

Thread: Coding regulations

  1. #1

    Default Coding regulations

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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, CPC-H, CEMC
    2014 President AAPC Swainsboro, GA Chapter
    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
    Join Date
    Apr 2007
    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. #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
    Join Date
    Apr 2007
    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. #6


    Thanks, thats what I thought.

Similar Threads

  1. Federal regulations?
    By Lynda Wetter in forum Auditing General Discussion
    Replies: 6
    Last Post: 06-17-2014, 05:13 AM
  2. Any billing regulations?
    By smoore0808 in forum Medicare Regulations
    Replies: 4
    Last Post: 05-23-2013, 09:09 AM
  3. Billing Regulations for a PA
    By csamps/CPC in forum Billing/Reimbursement
    Replies: 2
    Last Post: 05-28-2010, 11:16 AM
  4. Hmo regulations
    By EMACHORRO in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-27-2009, 01:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.