# Coding regulations



## tham12005 (Dec 2, 2009)

I need documentation showing that a physician is not required to review every code selected before it is billed. Someone told our physicians that they must review everything we do before it is billed.


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## fredabrinson (Dec 9, 2009)

*No regulation*

I don't think you will find what you are looking for.  Providers are responsible for everything billed under their name/number, regardless of whether or not they personally review every service or item charged/billed.

Being responsible does not necessarily mean the provider has to review every code, but there should be appropriate staff members in place to give the provider confidence in all charging and billing.  Periodic audits of the practice should be conducted to verify these processes are in place and are working as "assumed".


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## mitchellde (Dec 9, 2009)

I agree I have never observed in writing where it states this, however the coder needs to review all documentation before assignment of codes.


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## pscott (Dec 28, 2009)

*Documentation for coding*

So, that brings me to a question I have been trying to get an answer to for weeks. Is it appropriate to get a DX from documentation not pertaining
to the date of service that you are coding? I was told to look in the chart at past visits for codes, but I'm not convinced that that's correct. Do you know
where I might find guidelines about that?


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## mitchellde (Dec 28, 2009)

You are never allowed to refer to previous documentation for dx that are not documented in the current encounter.  I believe that Coding Clinics have covered this issue many times.


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## pscott (Dec 28, 2009)

Thanks, thats what I thought.


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