CO6: Examine fraud and abuse concerns in the health professions and the HIM professional’s responsibility to manage effective compliance programs.
As an inpatient coder, you have been instructed b your coding supervisor to code all debridement’s as excisional. You are not comfortable with this practice and tried to discuss it with her, but she stated that you were to follow her instructions and not issue queries. You went to the HIM director, who only half-listened to your concerns, saying that the coding supervisor must have a good reason for the instruction. The other coders are following her instructions without questions.
You are reluctant to get into trouble for not following the instructions and equally worried that the coding supervisor will retaliate against you in some manner if you report this practice.
Instructions:
In a 2- 3 page paper essay
1. Examine and provide a minimum of 3 options you have in the case scenario.
2. Analyze the impact of the False Claims Act as it relates to this case.
3. Recommend strategies for the inpatient coder.
all debridement’s as excisional. You are not comfortable with this practice and tried to discuss it with her, but she stated that you were to follow her instructions and not issue queries. You went to the HIM director, who only half-listened to your concerns, saying that the coding supervisor must have a good reason for the instruction. The other coders are following her instructions without questions.
You are reluctant to get into trouble for not following the instructions and equally worried that the coding supervisor will retaliate against you in some manner if you report this practice.
