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Wiki Inclusive???

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Sage123

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Is there any way to see if something is inclusive other than getting a denial or trial and error?

Thank you.:eek::
 
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.
 
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.
 
SLP77 said:
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.
Click to expand...

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 :rolleyes:
 
SLP77 said:
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.
Click to expand...

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.
 
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.
 
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.
 
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