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Medical Coding
Question1:

  • Your text and coding guidelines mention the difference between physician-billing guidelines, such as in laboratory services, and the radiological procedural guidelines of supervision and interpretation as it relates to billing.
  • Give an example of the differences between the types of billing, what the guidelines include, and an example of a type of healthcare service billed.

Question 2:

  • Should the physician keep the money?
  • A Pain management specialist see 55 and older patients, the specialist would do one or two nerve block injection. The specialist; wanted his billers and coders to up code and code that he did three nerve block injections on the patient. The specialist did this for five years and made over 6 million dollars from Medicare.
  • If you work on Medicare fraud and abuse unit, would you demand that the specialist pay back the money to Medicare? Or because it is hard times for specialist would you let the specialist keep the money and continue practicing?

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