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Gastroenterology Coding Alert

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What Is the Most Vital Info on a Claim?

Published on Wed Sep 08, 2004

Question: I am trying to come up with a list for my gastroenterologists to follow before they submit an op report to the coding department. Is there a short list I can give them with the most important elements of a successful claim?

Idaho Subscriber

Answer: Diana Quicker, medical coder for a four-doctor gastroenterology practice in Sarasota, Fla., tells her doctors that she needs three things to turn notes and numbers on an operative report into dollars on a claim.
 
Quicker says that on her claims, she tries to make sure that all of the operative notes:
 

  • are legible.
     
  • are given to the coder before she processes the claim. Don't   submit any claim to the coding department unless the gastro who  provided the service has finished filling out the op report and included all notes and other documents.
     
  • include any unusual circumstances surrounding the patient visit. 
     
    "I have found that if I have the above information from my physicians, I have much success getting all my claims paid and I feel very confident in my coding," Quicker says.

     - Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, an independent coding consultant in Marietta, Ga.

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