Wiki Medical Coder graduate

[robarnett3@comcast.net]

I am currently working in a 6 physician urology practice and find myself having responsibilities in various areas of the billing cycle. With that said, although I have a broad spectrum of questions, a denial pattern arose with Novartis for service frequency. The patients involved all had multiple in-house care dates, as well as two or more procedures for cystoscopy with clot evacuation (CPT 52001).
Any advice with this area of billing would be appreciated.
I just joined the association and I am excited to use the many resources available both nationally and with my local chapter.
Any direction that you believe would be most beneficial for me as I prepare for my CPC exam would be great.

 

[RMac]

Cystos often deny for global as they're a surgical code; however, most don't have global days. you may need to appeal their decisions to avoide possible recoupments. i would start with calling them and asking what they're refering as too many services, and go from there. Pt's can receive multiple cysto proceedures as long as MDM is warranted/documented.

 

[robarnett3@comcast.net]

Thank you. Will do!