Cardiology Coding Alert
What Makes a Clean Claim?
Question: Our cardiology practice has recently had to appeal numerous claims. The denials are due to our office's insufficient initial reporting. What can we do to fix this?
California Subscriber
Answer: Your office can send clean claims the first time by using a simple checklist. To ensure accuracy before submitting a claim, take these actions:
• Make sure the policy number and ID number are accurate.
• Obtain insurance eligibility verification.
• Verify other patient information (proper name, birth date, address, etc.).
• Confirm the info the provider gave you for posting charged entries.
• Check that CPT and ICD-9 codes are up-to-date and as specific as possible.
• Make sure, if applicable, that you have the referral authorization number on the form and, if required, the referring doctor's national provider identifier (NPI).
-- You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC-CARDIO, President of CardiologyCoder.Com Inc. and compliance manager for several cardiology groups around the country.
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