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August 2015

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Tue, 25 Aug 2015 10:31:45 -0400
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UVM Flownet <[log in to unmask]>
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Thank you, Bill.  Your use of the term "code steering" was very helpful.  An internet search led me to this:

False Claims Act
 Provides criminal penalties for knowingly or willingly filing a false claim to a government program.
 ICD-9 codes can only be supplied by the ordering physician or a representative of that physician.
 It is against the law for a laboratory to change or supply an ICD-9-CM code to a test order submitted by a
physician.
 Code steering means to steer or direct a physician to supply an ICD-9 code that is payable. Code Steering is
illegal. The code must come from the patient's medical record.
 Missing ICD-9 codes cannot be obtained by copying them from a previous laboratory order.
 It is against the law to use the wrong ICD-9-CM code for the purpose of causing or increasing payment for a
test.

How do we assist outside physicians in finding an appropriate ICD-10 code, especially with so many new ones coming up?  We still get a fair number of orders for arterials with an indication of swelling.  The schedulers indicated that it was a burden to call every referring provider to get the appropriate diagnosis code.  How are other labs that have a large referral base handling this?  We're obviously not doing it correctly right now, so I want to make sure that we do, but in a way that isn't a burden for us or referring providers.

Thank you for your feedback, Bill!

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