Wiki Surgery coding

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truggs4

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Is there a course available on orthopedic surgery reimbursement for workers compensation cases. The work comp carriers seem to be paying what they want and not was is required.
 
truggs4 said:
Is there a course available on orthopedic surgery reimbursement for workers compensation cases. The work comp carriers seem to be paying what they want and not was is required.
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Do you have the fee schedule for your state? I would start there. Each code has a value and based on your region that's how you can calculate the payment.
 
surgery coding

yes, but carriers aren't always paying all the CPT codes quoting CCI edits, so I am hoping there is a tool that states which CPT codes are bundled and which are not.
 
I do know that a lot of Workers' Comp follow Medicare guidelines. At least in California they do. Make sure to not only look at NCCI edits but the MU edits too. Appeal it if yoi have documentation that prooves it can be coded & billed this way.
 
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