To Do or Not To Do
Storyboard Text
- This is going to be a great day
- We need to code instances of unstable angina that occur after admission using code I21.4 non-ST elevation myocardial infarction (NSTEMI)
- HMM this does not sit right with me
- This is noncompliant with official coding guidelines
- The supervisor informed me to use code I21.4 instead of what the cardiologist documented in his report.
- compliance means performing job functions according to the laws, regulations, and guidelines it helps prevent fraud, waste or abuse within a healthcare entity.
- Fraud is an intentional deception or misrepresentation of fact that can result in unauthorized benefit or payment
- Abuse describes practices that may directly or indirectly result in unnecessary costs to medicare program . This situation is considered fraud.
- Actions & steps1. Meet with the supervisor to discuss the issue. show her documentation supporting the inappropriateness of the coding practice in question.2. Remember my code of ethnics and what they stand for.
- Coding Standards and Guidelines1.1 Support selection of appropriate diagnostic, procedures and other types of health services related codes.1.2 Develop and comply with comprehensive internal coding policies and procedures that are consistent with requirements.1.3 Foster an environment that supports honest and ethical coding practices resulting in accurate and reliable data.
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