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sequencing of CPT coding affect REIMBURSEMENT!

  1. Question sequencing of CPT coding affect REIMBURSEMENT!
    Medical Coding Books
    Does sequencing of CPT coding affect REIMBURSEMENT! I'm coding physician's facility and non-facility. What or where can I get something in writing?
    “I know for audit purposes it will.”

    Everyone's advice will help!

  2. #2
    Red face Sequencing... yes!
    Quote Originally Posted by ciwil123 View Post
    Does sequencing of CPT coding affect REIMBURSEMENT! I'm coding physician's facility and non-facility. What or where can I get something in writing?
    “I know for audit purposes it will.”

    Everyone's advice will help!
    The conventions and guidelines in coding education have always urged coding "worst first." That is a basic guideline for sequencing your CPT codes. I have never been faced with your dilemma. However; you should make sure you have listed your primary code preceding any manifestations.

  3. #3
    Default
    Hi--
    If your services span 2 or more days, you are supposed to list the services chronologically...within each day, list the E/M code(s) first followed by the highest RVU values...when we used to bill the Medicare carrier, they would re-arrange our codes as such...
    hope this helps CPC-P

  4. #4
    Default
    It may also depend on the carrier. I have been auditing surgery charts for an orthopaedic practice where they perform 25310 and 25447 together. One of our local carriers pays the 25447 as primary even though the 25310 has the higher RVU value. They have met with the carrier and per the carrier, the main reason for the surgery is the 25447.

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