Discuss the results of under coding and over coding of CPT & HCPCS codes. Include the possibility of fines, imprisonment and shut down of the health care facility.
What will be an ideal response?
Under coding can result in not coding something because it may raise a red flag, because it does not get paid, or you do not think it should be coded.
Over coding is when someone tries to level a visit higher because it is close enough, when a bundle service is billed separately when it should be included, or when something is done but not documented.
Documentation is key to coding, and if it was not documented it did not happen!
Insurance carriers will audit. If they find errors, they can fine the providers, and if the amounts are substantial or fraudulent then the result can be jail time.
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What will be an ideal response?
Which of the following points are NOT important in planning a safe lesson?
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