Sage123
Networker
Is there any way to see if something is inclusive other than getting a denial or trial and error?
Thank you.
:
Thank you.
:-
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Wiki Inclusive???
- Thread starter Sage123
- Start date
lpick
Contributor
Claimcheck
I am having issues too. Are you speaking of claimcheck? Tricare? BCBS? We are having issues with both.
I am having issues too. Are you speaking of claimcheck? Tricare? BCBS? We are having issues with both.
mhstrauss
True Blue
Is there any way to see if something is inclusive other than getting a denial or trial and error?
Thank you.
CMS's NCCI Edits is usually a good place to start; here's the link:
https://www.cms.gov/NationalCorrectCodInitEd/NCCIEP/list.asp#TopOfPage
Select the code range for the codes you are dealing with, and it lists the codes that it considers included in a spreadsheet.
Sage123
Networker
Thank you mhstrauss. We have been using the NCCI but it's not showing anything. I was just wondering if there was another way other to know other than being told all the time.
Sage123
Networker
Ipick.
I was just talking in the general sense. I've not heard of claimcheck yet.
I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
Thank you.
I was just talking in the general sense. I've not heard of claimcheck yet.
I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
Thank you.
mhstrauss
True Blue
Any particular scenario you want advice on? I know all payers have their quirks about inclusions and such...really makes it difficult to know what you can actually code and still be compliant
mhstrauss
True Blue
I'm the same way. I handled United Healthcare denials before I got my cert, and just got used to the way they did things.
Sage123
Networker
I feel for you on the UHC. I know how they are as well. Thank you but I don't have anything to give you.
I'm sorry. I thought maybe there was something else out there that might help but from what I can tell it's trial and error. Again thank you.
I'm sorry. I thought maybe there was something else out there that might help but from what I can tell it's trial and error. Again thank you.
fishbite2
Contributor
Some payors, including UHC, have claims/payment estimators on their websites. You put in the codes and diagnoses and it shows you how it will pay. Not foolproof but very helpful. I mainly rely the CMS NCCI Edits but not all payors follow them. Also, depending on your specialty the Coding Companion books have a lot of information on what is commonly considered to be inclusive.
Sage123
Networker
Thank you fishbite2.