Results 1 to 10 of 10

Inclusive???

  1. #1
    Smile Inclusive???
    Medical Coding Books
    Is there any way to see if something is inclusive other than getting a denial or trial and error?

    Thank you.:

  2. #2
    Default Claimcheck
    I am having issues too. Are you speaking of claimcheck? Tricare? BCBS? We are having issues with both.

  3. #3
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by SLP77 View Post
    Is there any way to see if something is inclusive other than getting a denial or trial and error?

    Thank you.:
    CMS's NCCI Edits is usually a good place to start; here's the link:

    https://www.cms.gov/NationalCorrectC....asp#TopOfPage

    Select the code range for the codes you are dealing with, and it lists the codes that it considers included in a spreadsheet.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  4. #4
    Default
    Thank you mhstrauss. We have been using the NCCI but it's not showing anything. I was just wondering if there was another way other to know other than being told all the time.

  5. #5
    Default
    Ipick.
    I was just talking in the general sense. I've not heard of claimcheck yet.
    I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
    Thank you.

  6. #6
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by SLP77 View Post
    Thank you mhstrauss. We have been using the NCCI but it's not showing anything. I was just wondering if there was another way other to know other than being told all the time.
    Any particular scenario you want advice on? I know all payers have their quirks about inclusions and such...really makes it difficult to know what you can actually code and still be compliant
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  7. #7
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by SLP77 View Post
    Ipick.
    I was just talking in the general sense. I've not heard of claimcheck yet.
    I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
    Thank you.
    I'm the same way. I handled United Healthcare denials before I got my cert, and just got used to the way they did things.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  8. #8
    Default
    I feel for you on the UHC. I know how they are as well. Thank you but I don't have anything to give you.
    I'm sorry. I thought maybe there was something else out there that might help but from what I can tell it's trial and error. Again thank you.

  9. #9
    Default
    Some payors, including UHC, have claims/payment estimators on their websites. You put in the codes and diagnoses and it shows you how it will pay. Not foolproof but very helpful. I mainly rely the CMS NCCI Edits but not all payors follow them. Also, depending on your specialty the Coding Companion books have a lot of information on what is commonly considered to be inclusive.

  10. #10
    Default
    Thank you fishbite2.

Similar Threads

  1. would you consider these visits inclusive or not?
    By dgummersall in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-21-2012, 11:11 AM
  2. Is this inclusive?
    By elora81 in forum Modifiers
    Replies: 6
    Last Post: 06-30-2012, 09:24 PM
  3. inclusive or not
    By PEH350 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 01-21-2012, 09:43 AM
  4. Cystoscopy inclusive
    By jeremyj in forum Urology
    Replies: 0
    Last Post: 01-10-2012, 03:18 PM
  5. inclusive?
    By bench in forum Outpatient Facilities
    Replies: 1
    Last Post: 08-05-2009, 05:09 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?

Login

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.