Question

PLEASE ANSWER ALL THE QUESTIONS:

1) The TOPIC is Computer Assisted Coding (CAC) and the information that should be included in this should address the 5 W's:Who or What, Why, Where, When and also How it impacts medical coding.

2) Define Up Coding and Down Coding? Are they viewed the same by the OIG (Office of Inspector General)? (Explain).

Answer 1

1)Computer assisted coding is a software in healthcare industry used for medical coder accuracy and improve its quality in coding.It analyses the health status and gives appropriate codes.It mainly relies on who codes it for disease condition and procedures,what is the benefits behind it, where it is done ( hospital,clinics,healthcare organizations, insurance company) why it is coded (necessity) and usually done at the time of discharge or when leaving the health sector

2)Up coding refers to the physician doing medical bills to the health insurance payer which is done for a very expensive procedure or services offered.As a result it may have a effects on the health and financial status and health

Down coding refers to the provider bills the insurance payer in lower level than the services offered.

Both can raise legal issue and defame the name of the healthcare organization and the healthcare professionals.