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Procedure Codes

  1. #1
    Post Procedure Codes
    Medical Coding Books
    I was just curious - can you bill an office visit instead of a prodecure code (i.e. FB removal; wart treatment). Does it say anywhere that you could get dinged on an audit if you use an office visit code for a wart removal when you know that is what they are coming in for? I am getting so many complaints about the cost of the wart treatment - and not being covered by insurance because it was billed as a surgical code. Any advice? What do others do and how to you explain this to your unhappy parent?

  2. #2
    Columbia, MO
    You cannot substitute one code for another, especially if it is a billing issue. Whether it is to try and increase a charge or decrease a charge. The codes must reflect what is documented.

  3. #3
    I agree. If the procedure is what is being done, the procedure gets billed.

    Unfortunately, there are always going to be patient issues with their bills. We just keep explaining that it has to be billed by what was done and that is the way it is. We have people in the patient financial area who will work with them if they need to make payments, so we let them know that too. It's not easy keeping up with more and more medical bills with today's economy and it's not an easy job to be the one to listen to complaints.

    Hang in there!
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

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