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Wiki How To Deal With Collision Coding
- Thread starter rrmclain
- Start date
mitchellde
True Blue
I not understanding the issue . Can you provide example ?
64494 is hardcoded in our CDM so when the Dept. submits the charge, the code drops on the claim along side the description under Rev Code 360. In the case I am reviewing the patient had Bilateral Facet Blocks L4-5, L5-S1 and that is why the additional charge of 64494 was entered by the Dept. for the 2nd injection. In this case the coders softcoded 64493-50 and 64494-50. On the claim the 64493-50 was placed on the OPS surgery line (correctly) but the additional softcode of 64494-50 droped on a line without a charge. The payor is obviously rejecting the claim because only one procedure can be done per day but the claim is listing 2 units for 64494. Our billing and coding are being outsourced but when we had on-site staff, our billers "knew" to remove the "extra" soft coded procedure or contacted the Dept. or the coders to coordinate what would be sent on the claim.