tci Part B Insider - 2003 Issue 20

Rash of Subpoenas Hits Coders Hard - Managed-Care Plans Seek Coding Nitty-Gritty

Are you now, or have you ever been, an upcoder? That's what the managed-care industry seems to want to know. The health plans defending themselves against a lawsuit filed by physician groups demanded a veritable warehouse full of paper from coders and coding experts. The subpoenas from eight of the biggest managed-care companies seek information on coding seminars and consulting services provided by coding experts. They cast as wide a net as possible and ask for documents about "the use of CPT Codes or CPT modifiers to increase, maximize or optimize payments for medical services." (The Coding Institute...

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