Wiki Certified Newbie asked to Train Staff

[bbp18@hotmail.com]

Ok, so I am a CPC-A with no real world experience. However, since I have worked in Cardiology for the past eleven years as a Cath Lab tech, one of the physicians I work with has asked me to come and train his biller (who has no knowledge in A&P, medical terminology, or code sets). They are getting a lot of denials because she isn't coding correctly. Where do I start?

 

[JudyW]

Ok, so I am a CPC-A with no real world experience. However, since I have worked in Cardiology for the past eleven years as a Cath Lab tech, one of the physicians I work with has asked me to come and train his biller (who has no knowledge in A&P, medical terminology, or code sets). They are getting a lot of denials because she isn't coding correctly. Where do I start?

I would start with the denials. Work with them as to why they were denied and show them how to correct them and refile the corrective claim. I would make them do the claims after you have shown them one or two so that they can learn from their mistakes. If no one ever has to correct what they have done wrong they will not learn. I is just my opinon. Good Luck

 

[MarcusM]

coding

Most likely the claims are getting denied as the diagnosis code is not medically necessary for the procedure. It is critical to match the correct diagnosis code with the suitable procedure. The Medicare LCD will help to figure out the correct diagnosis codes with the procedures.