Medical Auditing Practice Exam

What should a compliance officer document when a coding violation is reported?

1. The weather on the date of the incident

2. The date of incident, name of reporting party, name of responsible person, follow-up action taken

3. Only the name of the reporting party

4. Details of the financial implications

The correct answer is: The date of incident, name of reporting party, name of responsible person, follow-up action taken

When a compliance officer documents a coding violation that has been reported, it is crucial to record comprehensive information to ensure proper follow-up and accountability within the compliance process. Documenting the date of the incident provides a timeline for when the violation occurred, which can be important for tracking patterns or issues over time. Including the name of the reporting party is essential to establish who raised the concern, facilitating any necessary follow-up or communication regarding the incident. Moreover, noting the name of the responsible person helps identify who was in charge of the coding process at the time of the violation, which is important for understanding the context of the error and determining whether additional training or corrective action is needed. Lastly, recording the follow-up action taken ensures there is a documented response to the violation, which is critical for the accountability of the compliance program and can inform future best practices. The inclusion of all these elements creates a clear and actionable record that contributes to the effectiveness of the compliance program, supports the organization's integrity, and helps mitigate the risk of future violations.