Wiki Procedure Coding

[Mindy Davis]

Does anyone know of any ED Procedure coding seminars? I would like to make sure that I'm billing procedures correctly and that I'm capturing everything I should be.

 

[lcomeaux]

The American College of Emergency Physicians will be having a Reimbursement Trends and Strategies in EM & Advanced Procedure Coding for EM session May 23-27, 2010 in Scottsdale, AZ. Check out www.acep.org for more information.

 

[Davieda Skobel]

E/M's and procedures

I have recently been going round and round with a payer that does not want to pay an E/m with a procedure. They are paying the procedure but denying the E/M no matter how well the Docs are documenting. We ahd a computer glitch for a span of 8 weeks that dropped our modifier 25 off the claim prior to submission so they all got denied and they told us instead of just adding the modifier and resubmitting them, we had to appeal them all with notes. We did all that work and needless to say they denied them all again. Before the glitch they paid them and after the glitch they paid them but during the 8 weeks they refuse to pay. Anyone have any ideas? It is a significant amount of money. They have threatened us with auditing all our claims with 25 modifiers on them. Help!!!!!

 

[Mindy Davis]

Well if your docs done the work and it is well document I would welcome an audit to prove to that insurance company the work was performed.

 

[elora81]

Dermabond inquiry

In need of some assistance, I do coding for the physicians that render services at an Emergency Room. They do minor procedures like simple laceration closures, we are questioning the introduction of a code given to us (G0168) for these service whereas in the CPT book the definition under Repair states to use the codes in the section (12001-12057) to designate wound closure utilizing sutures, staples, or tissue adhesives (eg, 2-cyanoacrylate), either singly or in combination with each other, or in combination with adhesive strips. Which code would be more appropriate to use based on coding only for the physicians of the ED?

 

[kak6]

We used G0168 only for Medicare, and only for closure using tissue adhesives only. Not for sutures, staples, ect. All com. carriers we would use the appropriate CPT code.