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Thread: Insurance saying Dr. billing incorrectly

  1. #11
    Join Date
    Apr 2007
    Coastal Coders


    AAPC: Back to School
    I have been on both sides of this issue. When I worked for a major insurance company we were told emphatically that we were not to dispute the provider's coding when patients called. And definitely not to offer our opinion on what the coding should be.

    Now I am in a plastic surgery practice and get calls from patients wanting us to change our diagnosis code on cosmetic surgery so their insurance will cover it. It's a never-ending problem.

  2. #12
    Join Date
    Apr 2007
    Lauderdale Lakes


    I have also had issues with some insurance companies where I would bill a screening colon for example as 45380-33 with V76.51, 211.3. The insurance will see that there was a polyp even when the 211.3 is second and process it as diagnostic.

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