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coder liability

Kelly Posted Mon 15th of February, 2016 10:33:15 AM

I have a doc who wants to code 32557 for ALL of his pleural drainages even when a catheter has been left in. I have supplied him with resources for education and he is insistant to always code 32557. In the event of an audit could I also be held liable for incorrectly coding 32557 or any other incorrect coding

Kelly Posted Mon 15th of February, 2016 10:35:23 AM

In the above I meant to say when a cath has NOT been left in place

SuperCoder Answered Tue 16th of February, 2016 02:05:50 AM

It is always good to abide by the coding ethics and not indulge in improper coding. Even agreeing to, or hiding improper coding is your liability as it violates the coding laws. I suggest you to communicate with your doctor and bring to his notice that the code he often uses is not appropriate every time. You may educate the doctor about the documentation requirements needed to support the billing. Hope this helps!!

Kelly Posted Tue 16th of February, 2016 09:24:32 AM

I have provided education to him. I went onto the OIG site looking for anything in writing that states a coder can also be held liable but could not find anything. Can you direct me to any resources that state anyone knowingly submitting incorrect coding will be held liable

SuperCoder Answered Wed 17th of February, 2016 02:43:58 AM

You may find the following articles helpful:
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Fraud_and_Abuse.pdf

http://www.justice.gov/sites/default/files/civil/legacy/2011/04/22/C-FRAUDS_FCA_Primer.pdf

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