Doug Henley, MD, a member of the editorial panel, said the group wants to consider state and specialty input as well as discussion from the fly-in before agreeing on recommending changes to the guidelines. The panel could consider additional changes at its August meeting. A HCFA representative sits on the CPT panel, but the agency must approve any of its recommendations. Fraud fears With the guidelines' content still uncertain, the government has yet to mount aggressive actions against physicians for failure to adhere to the standards. But with the government's high-profile war against perceived fraud and abuse in full blaze, doctors worry about the ramifications of instilling highly specific guidelines.
Most coding errors are unintentional.
The AMA should be standing and shouting that we shouldn't be treated as crooks. Among other goals, the Association will insist that coding standards not be applied retroactively. Dr. Reardon noted that coding ambiguities are fairly common. At the same time, he said he was unaware of any government fraud actions against physicians for simple coding errors. The action plan would also establish and clarify the distinction between CPT guidelines and carrier audit criteria, which are a HCFA product.