I recently returned to coding and billing. I have been out of the loop since 2005 but am currently in ISP and on my way to certification, hopefully before the end of this year. I am a little rusty but trying to jump back in. I have been hired part time/temp to help a local Internist clean up some problems with his medicare billing. I have found several technical problems but have fixed those. I am now reviewing actual claims and am finding coding errors.

Here is my question: How do I explain to the permanent biller/coder that a claim that was paid should not have been. I see several claims coded the same way that were denied and a hand full of claims that were actually paid (99214-25,99354-59).

Please help me come up with a diplomatic way to let Dr and biller know those few should not have been paid and why they were.