Wiki matching diagnosis codes

[Colliemom]

I recently had a physician ask the following question:

How crucial is it that the post-op findings of the surgeon and the facility match?

What is your opinion? There are occasions when the surgeon submits his/her findings (postoperative dx) immediately after completing the surgery. The hospital may have a delay in submitting their facility charges for the surgery. Which means the pathology report, which wasn't available until 5 days after the surgery, can effect what dx code the hospital bills. (while the surgeon, who submitted his billing the same day as the surgery, may have a different dx, because he/she did not have the path report available for review at that time.) So my physician's concern is, how crucial is it that the dx code billed by the surgeon and the facility match?

 

[Colliemom]

And yes, it would be better for the surgeon to wait for the pathology report to come back before submitting a claim for the service. But there are occasions where the billing needs to be submitted immediately. (end of month, end of year, etc)

 

[Colliemom]

Anyone?

 

[tigner]

Radiation therapy 77387

Anyone?

using 77387 for part of the radiation therapy but Insurance's are denying no matter if have Mod 26 or not, does anyone know is there an other CPTY code to use that would be payable for this service