Wiki Inpt coding help!

[ajijon]

A patient was already inpt at the hospital for a surgical procedure and following that procedure he fell in the hospital which caused a laceration on his eyebrow. My surgeon was called in to do the laceration repair. We billed it to the insurance and they denied for no prior auth. How can we fix this?


Thanks!

 

[jmartinez0421]

Have you tried speaking to the Auth dept. to try to obtain retro auth. They might want documentation, shouldn't be a big deal. good luck!

 

[zafiro18]

Never Events

You will have to be careful about this situation. This could qualify as a never event. A never event will not get paid even if you do get the authorization. I think that there is more information about never events on Novitas's website.