USC Care Medical Group Compliance Standards

The USC Care Medical Group/Doctors of USC is fully aligned with all policies of the University of Southern California. Through its compliance activities, the medical group embraces and supports the USC Code of Ethics and the USC Healthcare Compliance Program.

Over the years, a number of policies and procedures have been provided to help with guidance in billing. We hope you find the information contained in this website to be educational and helpful to you in the daily operations of your practice. The compliance program policies and procedures apply to all university personnel as well as billing vendors involved in the provision of and documentation or billing for professional medical and/or healthcare services.

Billing B-400, Centralization of Billing Information

B-401, Uniformity of Encounter Forms

B-403, Insurance Rejections and Denials

B-404, No Charge Visits & Insurance as Full Payment Billings

B-405 Processing Credit Balances

B-406, Billing for Teaching Physicians

B-407, Billing for Fellows Participating in Private Practice

B-409, Billing of Incident-to Services by Ancillary Staff

B-410, Collection Agencies

B-411, Billing Rules Applying to Non-Physician Practitioners

BS-143 Processing Refunds

Documentation and Coding DC-300, General Medical Record Documentation Standard

DC-301, Revising Clinical Record Documentation

DC-302, Coding

DC-304 General Documentation and Coding Guidelines for Evaluation and Management

DC-305, Evaluation and Management Codes for Hospital Inpatient Services

DC-306, Evaluation and Management Codes Hospital Observation Services

DC-307, Evaluation and Management Codes for Hospital Outpatient Services

DC-308 Time Based Services – Counseling and Coordination of Care

DC-309 Time Based Services – Critical Care Services

DC-310, Neonatal Intensive Care Services

DC-311, Prolonged Services

DC-312, General Teaching Documentation and Coding Guidelines for Surgical Specialty

DC-313, Teaching Documentation and Coding Guidelines for Overlapping (Concurrent) Surgeries

DC-314, General Teaching Documentation and Coding Guidelines for Assistants at Surgery

DC-315, General Teaching Documentation and Coding Guidelines for Psychiatric Services

DC-316, General Teaching Documentation and Coding Guidelines for Endoscopy Procedures

DC-317, General Teaching Documentation and Coding Guidelines for Consultations

DC-318, General Teaching Documentation and Coding Guidelines for Anesthesia Services

DC-319, General Teaching Documentation and Coding Guidelines for Radiological Services

DC-320, General Teaching Documentation and Coding Guidelines for Medical Services Rendered at the Dental School and its Affiliated Centers and Programs

DC-321, General Teaching Documentation and Coding Guidelines for Pathology

DC-322, General Teaching Documentation and Coding Guidelines for Independent Billing of Physical and Occupational Therapy Services

DC-323, Medicare’s Primary Care Exception

DC-324, Scribes

DC-326, Documentation and Coding Guidelines for Intraoperative Neurophysiology Monitoring (IONM)

Education ED-200, Compliance Education
Monitoring and Auditing MA-500, Practice Plan Compliance Monitoring

MA-501, Quality Assurance Monitoring