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Thread: New Requirement for Medicare Billing 2012

  1. #1

    Default New Requirement for Medicare Billing 2012

    AAPC: Back to School
    Has anyone heard the rumor that as of January 2012 it will be required that to bill Medicare and Mediciad the persom must be a Certified Coder ?

  2. #2
    Join Date
    Apr 2007
    Tacoma, WA


    Just a rumor. It is highly suggested that providers use certified coders, but right now no agency can regulate who provides that service for a provider office.

  3. #3
    Join Date
    Apr 2007
    Jacksonville, FL (90417)

    Default Rumor based on recommendation

    It is a recommendation in the OIG's Compliance Program for Individual and Small Group practices - see the excerpt below or using the hyperlink scroll to page 59442.

    Final Compliance Program Guidance for Individual and Small Group Physician Practices (PDF) (65 FR 59434; October 5, 2000) http://http://oig.hhs.gov/authoritie.../physician.pdf

    “The OIG understands that most physician practices do not employ a professional coder and that the physician is often primarily responsible for all coding and billing.

    However, it is in the practice’s best interest to ensure that individuals who are directly involved with billing, coding or other aspects of the Federal health care programs receive extensive education specific to that individual’s responsibilities.

    Some examples of items that could be covered in coding and billing training include:
    1. Coding requirements;
    2. Claim development and submission processes;
    3. Signing a form for a physician without the physician’s authorization;
    4. Proper documentation of services rendered;
    5. Proper billing standards, procedures and submission of accurate bills for services or items rendered to Federal health care program beneficiaries and the legal sanctions for submitting deliberately false or reckless billings."

    Compliance being the hot topic that it is, more and more physician's and their practices are studying up on their requirements and the OIG is the best resource for this information. So the above is probably how the rumor came to be.

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