I don't know of any specific guideline from Medicare. But from what I've seen there are two key issues. One is how the return is worded. If the wording at all looks like the physician is being pushed to a higher level eg you could get to a 99285 if you add the 4th HPI, would be a compliance concern. The other issue is timing. The longer you give the physician to fix the chart the worse it looks.
Generally, in most cases in our field, charts are retuned post coding for educational purposes unless the chart is completely unbillibe as is. There are a couple of entities that do return pre billing; but they are very careful with wording and timing of the return.
Maybe the safest approach is to require new docs or residents attend an inservice when they join the group with several educational follow ups based on their coding.
Jim Strafford CEDC MCS-P
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join