Abstract

Accurate coding for proper reimbursement is important to all health care practitioners for many reasons. Nurse practitioners (NPs) are a group that is often involved in billing, either directly for their own services or by checking diagnostic and procedural codes on a billing form used by their employer to bill for their services. The NP or other professional provider is responsible for the accuracy of this coding and billing, as well as for maintaining medical records that verify and amplify the basis for the coding. An NP who knowingly or in deliberate ignorance cheats on coding to enhance his or her reimbursement may be guilty of both civil wrongs (including violation or breach of the insurance contract) and a crime, which can be costly to both the NP and any affiliated physicians or other practitioners.

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