Health information

Instructions: Complete Whistleblower case study (5.18) in “HIM Case Studies” by Diana Foley.  This case study is located in domain V, page 247.

Whistleblower

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Subdomain V.C.

Identify potential abuse or fraudulent trends through data analysis

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Subdomain V.A.1

Appraise current laws and standards related to health information initiatives

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As an inpatient coder, you have been instructed by your coding supervisor to code all debridements as excisional. You are not comfortable with this practice, and tried to discuss it with her, but she stated that you were to follow her instructions and not issue queries. You went to the HIM director who only half-listened to your concerns, saying that the coding supervisor must have a good reason for the instruction. The other coders are following her instructions without question.

You are reluctant to get into trouble for not following the instructions and equally worried that the coding supervisor will retaliate against you in some manner if you report this practice.

a.  Appraise the impact of the False Claims Act as it relates to this situation.( can be answered in either a minimum of 5 bullets or paragraph format. Either will suffice.)

b.  Assess your options in this situation. (paragraph minimum)

Number of Pages: 1 Page

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