What effect does the Medicare National Correct Coding Initiative have on the billing and coding process? Some of the most common errors in billing and coding can actually be very easily fixed. They generally come down to not using proper modifiers and this can often result in a service not being covered. This can be fixed by making sure one understands and uses proper modifiers.
Physicians Practice Medical practices are concentrating on critical practice changes inbut it is important not to lose focus on the basics of coding. Modifiers are two-digit codes added to a service that tell the payer of special circumstances. Why would someone randomly apply a modifier?
Misunderstanding, incorrect information, or a desire to get a claim paid. But for both compliance and revenue reasons, correct use of modifiers is critical. There are several good coding books on the market that exhaustively explain modifiers.
Selecting the wrong procedure code. With more than 75, CPT codes, it is easy to imagine selecting an incorrect procedure code. However, the source of this error is usually not confusion about the procedure performed.
Incomplete or inaccurate code descriptions on encounter forms, cheat sheets, and electronic charge systems are a significant source of error.
Failing to read the editorial comments at the start of the section in the CPT book or the notes near the code is another source for this type of error. Failing to link diagnosis codes. The diagnosis code tells the payer the reason for the service. Some patients present for more than one condition and may require unrelated services.
Other patients may receive a service that is only covered for a specific indication. For example, a patient presents to a family physician for hypertension, but has a wart destroyed at the same visit. The code for the office visit must be linked to hypertension, and the code for the wart destruction must be linked to the diagnosis code for warts.
Using a nurse visit in place of another service. As for the venipuncture, the practice motivation is that a nurse visit pays more than a venipuncture. But, it does not accurately describe the reason for the visit or the service performed.
If the reason for the visit and the service performed was venipuncture: If the patient presented for an allergy shot, bill for the administration of the allergen.
Assessing the patient pre- and post-shot is part of the payment for the administration.
Not keeping up to date. Medical practices and hospitals are understandably cautious about budgets. But failing to keep up to date on new coding rules and initiatives is an expensive mistake.
It results in lost revenue and potential compliance risk for practices. If you can avoid only one error this year, avoid not keeping up to date on coding. By doing that, you will avoid many of the other errors mentioned in this article.
Betsy Nicoletti is the founder of Codapedia.HCR Week 2 CheckPoint Medical Records Documentation and Billing HCR Week 2 DQ 1 And DQ 2 HCR Week 3 Assignment Understanding the Patient Intake Process HCR Week 7 CheckPoint Errors and Compliance in Coding HCR Week 8 Checkpoint Complete a CMS Claim Form HCR Week 8 DQ 1 And DQ 2.
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Write a to word response to the following: Briefly explain causes and solutions for three of the most common billing and coding errors. Email sending module: I am thinking of utilizing email module, what are the benefits? Business Rule EML9 (Email pending (in x days) vendor cost updates to buyers) sends out an automatic email to the buyer for cost updates scheduled.
Briefly Explain Causes And Solutions For Three Of The Most Common Billing And Coding Errors Billing coding and compliance strategies take some learning and some practice but they can be done easily with the correct knowledge. Write a to word response to the following: Briefly explain causes and solutions for three of the most common billing and coding errors.
What effect does the Medicare National Correct Coding Initiative have on the billing .