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Coding Practice/Policy for Correction

  1. Question Coding Practice/Policy for Correction
    Medical Coding Books
    What are your practice/policies on correcting coding? If the provider has the documentation but the code selected is not accurate or correct - do you change the code or do you consult with the provider first?

    Thank you, Leslie

  2. Default
    I would think that the policy would be based on that of your employer. It is my understanding that as a Coder it is our job to determine the appropriate codes. The determined codes based on the documentation provided may or may not always reflect the same codes as the provider selection.

    Try to think of it this way... If the provider documented multiple procedures but only selected a code for one, would you consult the provide prior to adding appropriate codes to increase reimbursement?

    Hope this helps!
    Tracey Thompson, CPC, CPPM

  3. Default
    I change the code and tell them why the code was changed, if down coding I give them an idea of the difference in reimbursement so they get an idea of how much a little bit more documentation could get them.

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