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lehill

  1. Default lehill
    Exam Training Packages
    Does anyone know if there is a "requirement" that the medical provider is the one who should chose the level of service for his E/M service? I am looking for something in writing.

  2. #2
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    Hey,
    I have never seen anything in writting. My physicians choose their LOS however if I see its wrong I change it to the correct level.

  3. #3
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    There is no requirement that the physician choose the level of service personally. That's why he/she has coders on staff.
    Walker Bachman, CPC, CPPM

  4. #4
    Default Physician Chooses Level of Service?
    My understanding is that if the Dr. submits a charge ticket with a level of service marked that you cannot make a change uness he/she is queried and the change is authorized. I guess it would be different if the Dr. submitted the documentation only and the coder made the selection based on the documentation provided.

  5. #5
    Default
    Quote Originally Posted by bettze1947 View Post
    My understanding is that if the Dr. submits a charge ticket with a level of service marked that you cannot make a change uness he/she is queried and the change is authorized. I guess it would be different if the Dr. submitted the documentation only and the coder made the selection based on the documentation provided.
    There is no law that I am aware of that stipulates this. The code submitted on the claim should reflect the documentation. Physicians are not coders and do not always choose the proper level of service. It may be your company's policy that the physician authorize any changes, but it is not a legal requrement.

    ADDENDUM: If you work for a billing company, rather than the doctor, THEN you must get permission from the doctor to change the code. If you are an employee of the doctor, then you do not need permission unless your internal policies require it.
    Last edited by Walker22; 02-24-2010 at 08:11 AM. Reason: add addendum...
    Walker Bachman, CPC, CPPM

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