"Write-Offs"	Month 1- Physician's Fee 2021	Month 2- Physician's Fee 2021	Month 3- Physician's Fee 2021
Poor Documentation	CPT 13122 - complex repair each additional 5 cm or less(21) $153.13 x 21= $3,215.73	CPT 49320 - laparoscopy; Surgical, abdominal, peritoneal, diagnostic(25) $415.61 x 25= $10,390.25	CPT 19301 - Mastectomy, partial (12) $842.73 x 12= $10,112.76
No Authorization	CPT 14301 - adjacent tissue transfer and rearrangement 30.1 sq. cm to 60.0 sq. cm(30) $1,292.35 x 30= $38,770.50	CPT 47562 - Laparoscopic cholecystectomy (25) $845 x 25= $21,125	CPT 67028 - Intravitreal injection pharmacologic agent spx. (57) $101.25 x 57= $5,771.25
Frequency Issues	CPT 97140 -Manual therapy techniques (e.g., connective tissue massage, joint mobilization and manipulation, and manual traction) (15 minutes) (35) $30.20 x 35= $1,057 CPT 97110 -Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (15 minutes) (35) $32.86 x 35= $11,501.10	CPT 97140 -Manual therapy techniques (e.g., connective tissue massage, joint mobilization and manipulation, and manual traction) (15 minutes) (25) $30.20 x 25= $755 CPT 97110 -Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (15 minutes) (25) $32.86 x 25= $821.50	CPT 97140 -Manual therapy techniques (e.g., connective tissue massage, joint mobilization and manipulation, and manual traction) (15 minutes) (25) $32.20 x 25= $805 CPT 97110 -Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (15 minutes) (25) $32.86 x 25= $821.50
Coordination of Benefits	CPT 43775 Laparoscopy surgical, gastric restrictive, longitudinal gastrectomy (15) $1,438.90 x 15= $21, 583.50	S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline (17) $	CPT 43775 Laparoscopy surgical, gastric restrictive, longitudinal gastrectomy (10) $1,438.90 x 10= $14,389
Down-Coding of E/M codes	E/M level 3 99213 (142) $103.56 x 142= $14,705.52	E/M level 4 99214 (177) $146.23 x 177= $25,882.71	E/M level 5 99215 (137) $205.26 x 137= $28,120.62
Unbundling of procedure codes	CPT 38525 Biopsy lymph nodes deep axillary nodes (49) $560.07 x 49= $27,443.43	CPT 38900 Intraoperative sentinel lymph ID with dye injection (47) $176.30 x 47= $8,286.10	CPT 43281 - laparoscopy surgical; repair or para esophageal hernia, w/o mesh (22) $1,984.37 x 22= $43,656.14
Medicare reimbursement policy regarding assistant surgeons	CPT 29881- Arthroscopy of the knee surgical with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed (10) $667.39 X 10= $6,673.90	CPT 29880 - Arthroscopy of the knee surgical with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed (10) $691.59 x 10= $6,915.90	CPT 46083 - incision of thrombosed hemorrhoids, external (10) $258.37 x 10= $2,583.70
Monthly Total Amount:	$124,950.68	$74,176.46	$180,436.43

According to the above table what are some recommendations related to each write off scenario for Outpatient Monthly Write off CY 4th Quarter 2021.

1. poor documentation;
2. no authorization;
3. frequency issues;
4. coordination of benefits;
5. downcoding of E/M codes;
6. unbundling of procedure codes;
7. Medicare reimbursement policy regarding assistant surgeon.

2) Investigate potential fraud and abuse with these rejections that are written off, and justify the application of the AHIMA Code of Ethics. Determine the importance of coding quality and accuracy through ongoing monitoring and reporting. Recommend necessary procedures/policy for monitoring and reporting, documentation compliance and compliance with insurance reimbursement policy. Describe the role of the health information professional regarding coding quality, compliance, and reporting.Describe the role of the provider regarding clinical documentation improvement.