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Dec 6, 2023
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As an inpatient coder, you have been instructed by your coding supervisor to code all debridement's as
excisional. You are not comfortable with this practice and tried to discuss it with her. However, 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 question.
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.
Examine the situation and provide at least three options you have in this situation.
Assess the impact of the False Claims Act as it relates to this situation.
In this situation, I would revisit the topic with the HIM director to further explain my reason for having
withdrawals on the directions given by the coding supervisor, document the instructions given by to me
to ensure that the backlash falls upon my superiors who disregarded my concern, or lastly report this
practice and search for employment within a new facility that properly follow guidelines.
The False Claims Act (FCA) is a federal law that works to protect against cases of fraud, waste, and abuse
of government resources. The law forbids individuals from knowingly overcharging or selling the
government shoddy goods or in the context of healthcare medical services. The law relates to this
situation since the coding supervisor is knowingly advising her coding team to improperly code all
debridement's as excisional which will therefore result in overpayment.
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Hi and thanks for your question! Unfortunately we cannot answer this particular question due to its complexity. We've credited a question back to your account. Apologies for the inconvenience.
Ask Your Question Again
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Asked Jul 13, 2020
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