Gastroenterology Coding Alert

You Be the Expert:

What Is the Most Vital Info on a Claim?

Question: I am trying to come up with a list for my gastroenterologists to follow before they submit an op report to the coding department. Is there a short list I can give them with the most important elements of a successful claim?

Idaho Subscriber

Answer: Diana Quicker, medical coder for a four-doctor gastroenterology practice in Sarasota, Fla., tells her doctors that she needs three things to turn notes and numbers on an operative report into dollars on a claim.
 
Quicker says that on her claims, she tries to make sure that all of the operative notes:
  are legible.
  are given to the coder before she processes the claim. Don't   submit any claim to the coding department unless the gastro who  provided the service has finished filling out the op report and included all notes and other documents.
  include any unusual circumstances surrounding the patient visit. 
 
"I have found that if I have the above information from my physicians, I have much success getting all my claims paid and I feel very confident in my coding," Quicker says.  - Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, an independent coding consultant in Marietta, Ga.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Gastroenterology Coding Alert

View All