i am a case manager, RN and i need to ask a ? about my new DON
she is supposed to be an expert at coding and telling me how to code certain pts dx's
now if they are pvt ins i dont have a problem but what if they are mcare and i think she is telling me to "upcode", am i responsible when mcare comes back later and wants their money or even worse, if they say we are defrauding the govt?
i need to know where i stand and since ur a legal nurse i was hoping u could shed some lite on this for me
thanking u in advance,
s.davis rn