Is Your Practice Optimizing Coding Resources?
AAOSNow – December 2018
by Sarah Wiskerchen
If not, you may be at risk for claim denials or lost revenue
Is your billing team or third-party billing service using the right resources, rules, and guidelines when assembling claims and managing denials?
When substantiating coding or appealing claims, you must base your reasons on standard resources, applied in the correct order. Several recent projects highlight the importance of properly utilizing the guidelines found in the Current Procedural Terminology (CPT), AAOS Global Service Data, National Correct Coding Initiative (NCCI), and other coding tools. If your coding team improperly follows these guidelines, your billing patterns could incite a potential review of records or result in incorrect code combinations, resulting in denials or lost revenue.
The following guidance can reduce unnecessary denials and reduce the risk of an audit.