Changing CPT Codes/Provider Permissions...

Coder-To-Coder Forum

Changing CPT Codes/Provider Permissions...

Ralph heath 07-04-2008, 3:01 AM

Hello,

I was wondering about what the official rules for changing CPT codes based on medical records. Is it necessary to get provider permission?

I've heard that legally you have to, and I've read that it depends on the policy of the institution. Anyone know?

Thanks!

Re: Changing CPT Codes/Provider Permissions...

Barb S. 07-07-2008, 9:15 AM

CMS and the AMA indicate that the diagnosis and procedure codes are the responsibility of the performing provider. I would always contact a provider before changing a code.

As a Coder you can be held personally responsible for the codes you bill. It makes sense that you would want to be in "code agreement" with the provider performing the service or procedure,

Re: Changing CPT Codes/Provider Permissions...

codingcat 07-14-2008, 10:17 AM
This post makes me wonder about a situation at a clinic I was involved with. One of the physician owners used to change codes on the other physicians charts- by changing the level of medical decision making. Is that legal?

Re: Changing CPT Codes/Provider Permissions...

Barb S. 07-14-2008, 2:04 PM
No..it's not legal.