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Otolaryngology Coding Alert

READER QUESTIONS:

Paper Claim Doesn't Have to Mean Slow Filling

Published on Tue Apr 18, 2006

Question: Our payer says we are not in compliance with -timely filing- requirements when we file paper claims for an unlisted-procedure code. What can we do?


Pennsylvania Subscriber


Answer: Many payers require electronic claims as proof of timely filing. But on many occasions--such as unlisted-procedure code claims, modifier 22 (Unusual procedural services) and reduced or discontinued service (modifier 52 or 53) claims--you must provide full documentation and therefore file a paper claim.

The solution is simple: File the claim electronically and then submit paper documentation separately. Be sure to include a note with the paper claim (or better yet, have a stamp made) explaining, -This is not a duplicate claim. This documentation supports an electronic claim.-
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