Podiatry Coding & Billing Alert

Answer: There isn’t a specific workaround, but you’ve already implemented an important step in fixing the problem by performing a self-audit. If you checked your records for common errors and found a few, create a list of common coding errors and distribute it throughout the practice without singling out certain employees. Such errors can prompt a denial needlessly, and everyone in the practice should be aware of when they’re making these types of mistakes, as well as how they can stop.

If this audit was performed retrospectively, meaning you already billed these claims, it’s possible you may have already found denials due to these issues. Claims with errors can always be rectified and resubmitted, or appealed if you believe they were unjustly denied. Appeals should be accompanied by a tailored, focused appeal letter. Besides referencing CPT^® and insurance guidelines, it’s important to personalize your appeals. This includes having the physician articulate, in their own terms, exactly what took place during the procedure.

“Many practices are finding it helpful to assess automation that may call out areas on the claim form that will trigger a front-end edit. You can customize these edits in many systems to specifically remind a user or billing team that this particular code can only be performed in this place of service. This may help you put a hard stop to many unnecessary errors,” suggests Jennifer McNamara, CPC, CCS, CRC, CPMA, CDEO, COSC, CGSC, COPC, director of healthcare training and practice support at Healthcare Inspired LLC. Bella Vista, Arkansas.