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University Physician Compliance is responsible for physician based compliance activities. The Office of Integrity and Compliance annually performs an internal coding and billing audit of Medicare compliance for all physician based departments. Audits focus on appropriate selection of diagnosis codes using the International Classification of Diseases, Ninth Revision, Clinical Modification and procedure/service codes using the Health Care Financing Administration’s Common Procedure Coding System, of which the American Medical Association’s Physicians’ Current Procedural Terminology, Fourth Edition system is a part. Health record entries are reviewed for completeness by applying documentation principles.
The physician compliance plan is maintained within this area. The subcommittee meets monthly to discuss the findings from each audit.
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