AAPC - Back to school
Results 1 to 3 of 3

Thread: Incidental Procedure According to Provider

  1. #1
    Join Date
    Apr 2007
    Fayetteville, North Carolina

    Default Incidental Procedure According to Provider

    AAPC: Back to School
    I am quite frustrated and am hoping someone can put a little sunshine back into the reason I have been coding for over 10 years. Let me start at the beginning, I started at my current employement 2 years ago. When I found out that the providers were No Charging patients for billable services, according the providers financial concern for the patient or personal relationship with the patient, I explained to them that it wasn't legal and that they should not do that. They put up a fight, mainly because they feel they are losing the "power" to choose who and how they bill. I don't blame them, I get it, but I also don't make the rules. So, with resistance we made policy on this issue. Now, we have been having many patient complaints about wart destruction and the cost of 17110 and that the doctor didn't tell them it was going to be an extra charge or it only took the doctor 3 seconds to do etc. . Mind you, if the coding department sees that the provider performed a procedure but did not charge for it, the coding department will add the appropriate procedure to that day's charges accordingly. Is this wrong? Due to the complaints, the providers wants to be able to NC for procedures when they (the provider) believes their services don't warrant an additional code/charge other then the office visit, even if, according to the coders, the documentation supports a procedure code.

    Any thoughts or opinions on this. I want to do what's right lawfully but to be honest, I am so spent on fighting this battle. If a policy was written, stating the providers can NC what ever service they want but when they do the coding department is released of all liability and responsibilty in relation to the codes assigned to that particular date of service, would this really relieve the coding deparment of responsibility if we were audited?

    Anyone's opinion or insight is much appreciated.
    Last edited by Stefanie; 10-05-2010 at 01:51 PM.

    Stefanie Cramer, CPC
    Sr. Coding Specialist
    Cape Fear Valley Health Systems

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Code correctly

    The provider should document what was done.
    The coder should code what was documented.

    By the way if you have a wart destruction, and that was the only reason for the visit, I would code the procedure and NOT code the visit.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Join Date
    Apr 2007
    Fayetteville, North Carolina


    I totally agree. The complaints and issues are when patient is in for other reasons, mostly wellness and the provider puts a "little" dot of beetle juice on a wart. They want to be able to determine whether it should be billed or not be billed. Can they decided if their service meets the criteria of a code, if so, am I worried about nothing?

    Stefanie Cramer, CPC
    Sr. Coding Specialist
    Cape Fear Valley Health Systems

Similar Threads

  1. Replies: 0
    Last Post: 10-02-2015, 01:47 PM
  2. can the rendering provider and referring provider be same
    By arunp_001 in forum Medicare Regulations
    Replies: 2
    Last Post: 03-02-2013, 12:15 PM
  3. Actual Provider Vs Billing Provider
    By YesicaRuedas in forum Billing/Reimbursement
    Replies: 1
    Last Post: 02-27-2013, 03:02 PM
  4. Provider billing E/M with procedure
    By cnramsey in forum Medical Coding General Discussion
    Replies: 11
    Last Post: 09-20-2011, 05:44 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.