Coding Manager Reviewed Explained for Students (Easy Guide)

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What This Question Is About

This question relates to coding manager reviewed and requires a structured academic response.

How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

This topic involves coding manager reviewed. A strong answer should include explanation, application, and examples.

Original Question

The HIM Coding Manager has reviewed recent claims submitted and finds a demand letter of fraudulent overpayment of 200 claims, which had their laboratory charges unbundled when submitted for payment. As a result, the facility was overpaid by $85.00 on each claim. The HIM Director pleads their case and explains that this is a first-time offense and was caused by three new coders. OIG accepts their appeal but requires them to repay the overage and action audit plan for the Coding Compliance Plan and that it be submitted to OIG for review. How much will the facility have to repay for the overage? What would have been the unbundling penalty against the facility if OIG had enforced the penalty? Explain unbundling, calculate the repayment, and calculate what the additional penalty would have cost the facility. What type of corrective actions should be included in the Coding Compliance Plan that should correct this issue?

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