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Correct Coding

CodingKing

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DOS then RVU order for physician if all on same claim form. Or split claim forms by DOS and then list in RVU ordere.
 
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do you know where the guideline is that states the correct way to go through your coding list? I have been instructed to code the highest dollar amounts and I've heard that you can't code that way that you code oldest date of service first.
 

thomas7331

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Are you talking about priority for coding, or the order to put the codes on a claim?

If you mean what work you should complete first, that would be up to your employer - they would decide based on their financial priorities. Often it will be a combination of the two - they'll want high dollars to go out quickly because more money is at risk and if there's a problem with the claim it will need to be identified and addressed right away. But at the same time, older claims are priority due to timely filing requirements. Your manager should guide you on this.

If you mean the order for codes on a claim, I don't know of any official guidelines for this, and the order really doesn't matter and won't affect payment as long the information is accurate. Most payer systems, and some providers systems too, will re-sequence the order of the codes and dates according to the system needs.
 
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ellzeycoding

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For same DOS, I recommend

  1. E/M first
  2. Procedures in descending RVU order (not your feees)
  3. Path/radiology services next
  4. Injections and J-codes last
 

CodingKing

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Even if you put them in the wrong order the billing system will typically reorder it anyways
 

ellzeycoding

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Even if you put them in the wrong order the billing system will typically reorder it anyways
There used to be a few (but not many) carriers that would take multiple surgery reductions based on the order the codes were submitted on the claim. So if you had a higher RVU surgical service that was coded beneath a lower RVU service on the claim, they would pay the first procedure (with lower RVU) at 100% and reduce the more expensive service. It wouldn't flag an error or anything unusual on the EOB. The providers would just get shorted some reimbursement. Sneaky bastards.

I think that's been improved upon (finally), but based on that I always teach putting procedures from high to low based on RVU just in case the odd carrier here or there still has that absurd programming in their system.
 
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