In my rather extensive experience with government and its auditing, the reason they hired teams of folks to assess whether a specific instance of mis-coding was or was not fraud was to ensure inappropriate cases from going to court or settlement. Ultimately, that came down to context: does the provider have qualified staff? Does the provider do his or her own coding and billing? Is the provider intentionally misrepresenting facts? I have never found that the government went in looking to shut a place down or take someone to court. Truthfully, it does not make any difference. If providers are not educated enough to hire a credentialed coder and make good choices about what entity performs the billing, then "spooking" them a little bit to taking it more seriously is not a bad thing. It will highlight our importance in all health care settings. Too many providers already "guess" at the coding anyhow, and expect one of us to fix it on the back end (if that's possible). If I-10 can help to rearrange the responsibilities, then great. I agree with mitchellde, a physician's job is two-fold: treat patients according to his/her clinical judgment and ensure the coding and billing are done by individuals qualified to do it. Write the notes, get out of our way and we'll chase you down the hall when we've got a question or concern.