tci Part B Insider - 2003 Issue 8

CODING: If You're Downcoding on Purpose, You're Burning Cash

Many physicians are so beaten down by fraud probes and carrier audits that they're punishing themselves before someone else can do it for them. That's the only way to read the findings of a physician survey sponsored by the Medicare Payment Advisory and the Project HOPE Center for Health Affairs. (See PBI, March 28, page 29.) More than two-thirds of physicians have billed "more conservatively than they felt was warranted" to reduce their chances of being investigated. Four out of 10 doctors downcoded occasionally, and another three in 10 downcoded on a regular basis, the survey found.The...

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