BC Advantage - 2013 Issue 12

Cloning Is Not Funny

By: Kathy Young, CEO, CPC, CPMA, Healthcare Chart AuditsAbout ten years ago I audited medical records for a provider who found himself in trouble with Blue Cross.  He coded pretty much every encounter as a level 4 office visit.  I reviewed the claims that Blue Cross had audited and then presented my report to the provider's attorney.  What I found was not what I had expected.  Instead of finding documentation that just did not support the coding, I found that each encounter looked almost exactly the same: pretty much word for word.  This was...

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