The Importance of Checking Your Medical Records for Correct Coding and Description

CHECKING FOR FALSE CODING IN YOUR MEDICAL BILLS

A recent case of false coding over billings for electro-acupuncture with the “P-Stim” stimulation device was recently settled in the Middle District of Tennessee this week, according to the United States Department of Justice (DOJ) online. The billings were submitted to either Medicare or TennCare under the presumption that these treatments referred to a neurostimulator implant rather than the temporary version that was used in its stead, according to the news release. The temporary version is not covered by Medicare.

Patients are rarely ever liable for any type of coding mistakes as this is controlled by your medical provider and typically, handled between the health provider and the healthcare payment systems. However, you may be affected if you can no longer get the treatment because, now, under the proper billing code, you are no longer eligible to receive the temporary version. This is true under any kind of medical billing, whether it is to Medicare, your regular healthcare plan, or Workers’ Compensation.

WORKERS’ COMPENSATION BILLINGS

While your billings are charged to Workers’ Compensation, it is wise to regularly check your accounts online as to what is being reported on your records. If you have doubts about medical coding, for example, you can call Medicare and find out what the proper coding is for your treatment. If you think your medical description is altered, get it corrected by your doctor when you go to your next appointment.

Always make sure that any prescriptions you are currently taking are properly documented, including why you are taking them. As an example, if you are on Prozac, you may be taking it for anxiety, which is not the same as depression or having suicidal tendencies. If you suddenly end up in a hospital, how you are treated for injuries or illnesses, depends greatly on what is in your medical records and why you are taking the listed prescriptions. Make sure this information is correct.

HOW DOES IMPROPER CODING AFFECT YOU?

Using the same example of suddenly ending up in the hospital because of an accident or illness, if a regular treatment you are getting is improperly coded, you may get treated in a different way instead. This could cause you harm if you are now receiving slightly different treatment than you used to get.

If you receive a different treatment, immediately ask about it and tell your attending healthcare provider what you usually get. This may alert the staff that a medical code is not correct in your records. The reason is not always intentional fraud but, perhaps, a case of carelessness when a medical code changes from one year to the next.

ANNUAL MEDICAL RECORDS CHECKUP

Make it a habit to check your records online every year. Chances are that you already do this if you are getting your lab results online sent to your primary doctor’s office. It is much easier to keep up with any changes when you can read lab results for yourself and be prepared to discuss them with your doctor next time you visit.

If you feel that there is a problem with your medical records and you cannot get them fixed, particularly where Workers’ Compensation is concerned, call an Arizona workers compensation attorney to get help. Arizona Injury Law Group offers experienced and Certified workers’ compensation lawyers and legal services for injured workers. Call for your free consultation! 602-346-9009.