arkassabaum
Contributor
Is it appropriate to not code a service because you know it will be denied? Recently I attended a rev cycle group meeting that discussed denials and common issues. One of them was 36415 being denied consistently. The suggestion was to leave this item off the claim all together for those payers denying the entire claim due to this cpt. I do not bill, so my opinion is this, I find it acceptable to leave it off the claim if the payer does not cover it and the claim is being denied. However, that being said I still believe coders need to pick that charge up and code the cpt in the encoder. As a coder, I was trained to code what services were provided regardless if the procedure/cpt is a covered service. I think of it for a compliance purpose, we need to track and monitor what services are coded and provided. Its what was done during the time of service so we code it. Now if the billing department needs to leave that off the claim due to denial, that's a separate issue to me. Please provide your thoughts.