• Home
  • About
    • Terms & Privacy
    • Calculate BMI
  • Contact
    • Authors
  • Articles Sitemap

Well Being Tips

Health Nutrition Exercises Beauty Social

Home › Health › 5 Medical Coding Tips to Keep You Claims in Slick Condition

5 Medical Coding Tips to Keep You Claims in Slick Condition

December 26, 2013 by dwillimes Leave a Comment

  • Facebook
  • Twitter
  • Pinterest

You know that your claims must support medical necessity for the services and procedures you’re your physician performs. Failing to do this, your insurance carriers will deny your claims outright or they may reimburse with you a lesser amount than you truly deserve.

Claim Denied Blood

In addition, the incorrect use of the ICD-9 diagnosis codes can land you in big trouble even when a procedure or service is appropriate and medically necessary. But you can reduce the chances of error greatly by reading the introduction to your ICD-9 manual for a summary of 5 Steps to Correct Coding. You can also pin these steps onto your desk and use them when forming claims.

Let us know see how you can keep your claims accurate:

1.       Start in the Index

You should begin your diagnosis and CPT® code search by first referring to the ICD-9 manual’s index, which is arranged alphabetically by condition. Also consult the volume 2 of the index, then cross-reference the codes you select using the tabular (Volume 1) listings. Then, read the exact definition of the code(s) you think are most appropriate. Also look for some additional information in the table that will help you make the right selection. If in confusion, visit your physician for clarification.

2.       Always report the diagnosis to the highest level of specificity

You must always use the fourth or fifth digits whenever they are available. It has been noticed that a number of times healthcare professionals restrict themselves to using a three-digit or four-digit code even when there are more specific fifth digits available under those headings. Thorough and specific reporting is the key to full and timely payment.

3.       Don’t stop. Report as many as you need

You should always strive to report the codes that describe the patient’s condition most accurately and specifically. Carefully read your physician’s documentation to support the claim. In you find anything unclear in the documentation or in case of confusion, consult your physician about how to report the diagnosis. Medicare allows you to report up to eight ICD-9 codes on a claim.

4.       Ensure accuracy in all cases

Successful diagnosis need to also establish medical necessity for any services and procedures that the physician performed on the patient. However, in case you notice that a particular diagnosis is not covered in the National Coverage Policy, then you may need to ask your physician for a letter and additional supporting documentation to prove that the procedure was medically necessary. Such cases may also necessitate a clinical review.

5.       Always follow the first rule of diagnosis coding

You must always follow the physician’s documentation to a tee and base your claims on it. You should never assign an ICD-9 code just in order to get payment by falsely proving medical necessity. Doing this might get you under the OIG scrutiny or may also cause you fraud charges, resulting in serious financial and criminal implications. This can also harm your patient outcomes.

Don’t waste another second searching for CPT® codes online! SuperCoder Medical Coding Blog will help you ensure you submit accurate ICD-9 diagnosis codes and perfect claims every time and you get complete reimbursement.

  • Facebook
  • Twitter
  • Pinterest
1 Star2 Stars3 Stars4 Stars5 Stars (1 votes, average: 4.00 out of 5)
Loading...

Filed Under: Health Tagged With: medical billing, Medical Coding

Related Posts

girl with dry mouth
Understanding Dry Mouth: The Symptoms, Why It Occurs & What To Do About It
kidney
7 Habits That Can Hurt Your Kidneys
nurse healthcare
What to Consider before Applying for a Job in the Healthcare Industry

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Daily Tips

heavy metals poisoning

Impact of Heavy Metal Poisoning on the Human Body

  • 7 Services Every Busy Person Should Consider

>> More Daily Tips

Health

nurse healthcare

What to Consider before Applying for a Job in the Healthcare Industry

  • Lung Cancer: The Factors that put you at Risk

>> More from Health

Nutrition

tinnitus

How Does Tinnitus 911 Work?

  • Pregnancy Nutrition: A List of Foods to Eat and Avoid (Infographic)

>> More from Nutrition

© 2021 · Wellbeing-Support.com