valerieeanderson
Networker
I know of a doc that is making his own guidelines and was wondering just how "bad" this was...
This doc has been known to change the diagnosis on a OP Note after getting a denial from an insurance company to "get the claim paid" for example the first diagnosis would read:
**Screening for colon cancer**
then it would be changed to:
**Rectal Bleed**
with no documentation in the op note about a rectal bleed!
Can someone tell me are you allowed to change your diagnosis codes after the claim has been billed AND denied?
Where is the definition for this situation? Any help you guys can provide I would greatly appreciate.
This doc has been known to change the diagnosis on a OP Note after getting a denial from an insurance company to "get the claim paid" for example the first diagnosis would read:
**Screening for colon cancer**
then it would be changed to:
**Rectal Bleed**
with no documentation in the op note about a rectal bleed!
Can someone tell me are you allowed to change your diagnosis codes after the claim has been billed AND denied?
Where is the definition for this situation? Any help you guys can provide I would greatly appreciate.