ED Coding & Reimbursement Alert - 2001 Issue 3
Reader Question: Coding Compliance Plans
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Article Overview
This reader Q&A covers the basics of building a coding compliance plan for small or individual physician practices. It discusses general compliance planning concepts, internal auditing approaches, documentation review, and the types of coding and billing risk areas highlighted in government guidance. The article is relevant to practice owners, coders, compliance staff, and auditors who want a general understanding of how a model compliance program is framed and why it matters.
Why This Topic Matters
Coding compliance planning affects how practices review claims, document services, and monitor risk areas for improper billing. Understanding the general framework helps practices evaluate whether they need a customized internal program and how to align audits and education with external compliance guidance.
What You Will Learn
- How a small practice may begin thinking about a coding compliance plan
- The general role of internal auditing in compliance efforts
- How broad risk areas are identified in model compliance guidance
- Why documentation review is part of compliance monitoring
- How compliance plans can function as educational tools for staff
Who Should Read This
- Physician practices
- Medical coders
- Compliance officers
- Practice administrators
- Revenue cycle staff
- Auditors
Codes Discussed
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