Medicare Compliance & Reimbursement

Confused about fifth digits or V codes? Look no further. Insurers base your reimbursement on whether your claims show medical necessity -- and you can't demonstrate that without accurate diagnosis codes. Refresh your ICD-9 coding skills with three tips that make ICD-9 coding a breeze: Tip 1: Forget that fifth digit and you'll forfeit your due reimbursement. If you omit a required fifth digit when submitting ICD-9 codes, such as those for arthritis (715.00-716.99),you can anticipate claim denials, delays, and potential payer rejections. "The purpose of the fifth digit is to allow the physician to provide greater detail, and when required it must be billed in order to facilitate reimbursement," says Susan Vogelberger, CPC, CPC-H, CPC-I, CMBS, CCP-P,president of Healthcare Consulting & Coding Education, LLC in Boardman, Ohio. "A code is invalid if it has not been coded to the full number of digits required." Fifth digits add additional information to [...]