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Fines for fraudlent coding

  1. #1
    Default
    Medical Coding Books
    Wrong section sorry
    Last edited by HBULLOCK; 07-21-2010 at 01:01 PM. Reason: WRONG SECTION

  2. #2
    Location
    Columbia, MO
    Posts
    12,837
    Default
    A coder is responsible for their coding. You should never submit codes that are not reflected in the documentation. Can you the coder be fined if the codes are incorrect? Yes you can! The thing is though they look for a pattern of incorrect submissions. Not just one claim incorrectly coded. If you know something is being submitted incorrectly can you be held liable if it is audited? Yes you can! If you know something that is fraudulent or suspect it then you have a duty to correct it or have it stopped. There are all kinds of ways you can be found either jointly or individually liable, and the only way to protect yourself is always code from the documentation and always follow coding rules and regs. The is coder malpractice insurance however from what I have read and been told the provisions of this insurance will not cover you if you submitted incorrect codes just to keep a job or because that is what you were told to do.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Dover Seacoast New Hampshire
    Posts
    2,015
    Default
    I'd check with your employer. My coding staff and I are covered under the hospital's insurance.

    Let's hope that the CPC after our names insures that we code to the highest standards, but it makes sense to find out if your employer has your back, just in case.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  4. #4
    Default Responsible coding
    Thank you debra. I am always careful to code correctly and do tell my doctors if there is something i dont agree with. I just didn't know anything about this insurance and i wondered if it was something that all coders routinely get.

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