Anesthesia Coding Alert
Defeat Denials by Conquering Top-10 Issues
Check this list to see if any problem spots look familiar If Medicare sometimes denies your claims on the grounds that you sent a duplicate claim or because you billed for bundled services, you're not alone. Here's a list of Medicare's top-10 denials, compiled by averaging data from nine different Medicare carriers: • duplicate claim submissions • bundled services • individual provider number and/or group number missing from 24k or 33 of the CMS-1500 form • the payer does not deem the diagnosis linked to the procedure a "medical necessity" for that service • Medicare is the secondary payer but is being billed as primary • noncovered services • patient is not a Medicare beneficiary • UPIN and name of ordering or referring physician is missing or invalid • incorrect modifier usage • procedure is a "screening" service and therefore not eligible for payment.
Anesthesia Coding Alert
- Documentation Checkpoint:
Stop Diagnosis Denials at the Door With Our Easy Checklist
Watch these 3 areas to help ensure clean anesthesia claims If you've compiled a list [...] - Quick Reference:
Defeat Denials by Conquering Top-10 Issues
Check this list to see if any problem spots look familiar If Medicare sometimes denies [...] - Pain Management Corner:
Knowing What IPM Specialists Do Is Half Your Coding Battle
Brush up on these procedures and codes before OIG comes calling As pain management continues [...] - You Be the Coder:
Verify Best Option for Piriformis Injection
Question: How should I code a piriformis muscle injection using fluoroscopic guidance? Washington Subscriber Answer: [...] - Reader Questions:
Concurrencies Count, Despite Different Payers
Question: Our anesthesiologist participated in two cases whose times overlapped. One claim is Medicare, and [...] - Reader Questions:
Medical Direction Status Stays for Entire Case
Question: Anesthesiologist A medically directed a CRNA during the first portion of a case. Anesthesiologist [...] - Reader Questions:
3 EEG Codes Include Anesthesia
Question: Some of our anesthesia providers will bill an EEG (CPT 95955) when performed, [...] - Reader Questions:
Go With Higher Base, Not Multiple Codes
Question: Should I include any modifiers when submitting claims for a double procedure, such as [...] - Reader Questions:
V58.69 Could Work for Chronic Narcotic Use
Question: What diagnosis should I use for chronic narcotic use? Louisiana Subscriber Answer: Some coders [...] - Reader Questions:
Confirm Nerve, Location for Occipital Destruction
Question: How should I code occipital nerve destruction? Indiana Subscriber Answer: Coders and payers sometimes [...] - Reader Questions:
Follow Payer Guides for Pump Payment
Question: How should we code spinal pump insertion for pain management? Our physician helped with [...]
