Coding 101:
Master the Do's and Don'ts of Unlisted-Procedure Coding
Published on Mon Oct 04, 2010
Answer these questions for your best chance of adequate reimbursement.Burn this CPT instruction into your brain: "Do not select a CPT code that merely approximates the service provided." This rule is key for compliant coding, but it leaves you with the tough job of submitting a claim without a procedure-specific code. Here are some do's and don'ts to help boost your chances of getting the payment your practice earned.Do Explain the Procedure in Layman's TermsIf CPT doesn't offer a code specific to the service provided, then you should report the appropriate unlisted-procedure code, such as 37799 (Unlisted procedure, vascular surgery) for vascular sclerotherapy.Any time you file a claim using an unlisted-procedure code you should include a cover letter stating why you are using the unlisted code, says Rebecca Lopez, CPC, coding specialist for Bright Health Physicians' compliance department in Whittier, Calif. This separate report should explain in simple, straightforward language [...]