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Coder-To-Coder Forum

Started by Ralph heath at 07-04-2008 3:01 AM. Topic has 3 replies.

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   07-04-2008, 3:01 AM
Ralph heath is not online. Last active: 8/14/2008 11:05:09 AM Ralph heath

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Joined on 06-30-2008
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Changing CPT Codes/Provider Permissions...
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!

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   07-07-2008, 9:15 AM
Barb S. is not online. Last active: 9/3/2008 7:44:00 PM Barb S.

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Joined on 12-21-2005
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Re: Changing CPT Codes/Provider Permissions...

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,


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   07-14-2008, 10:17 AM
codingcat is not online. Last active: 7/14/2008 9:13:37 PM codingcat

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Re: Changing CPT Codes/Provider Permissions...
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?

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   07-14-2008, 2:04 PM
Barb S. is not online. Last active: 9/3/2008 7:44:00 PM Barb S.

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Re: Changing CPT Codes/Provider Permissions...
No..it's not legal.
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