Page 1 of 2 12 LastLast
Results 1 to 10 of 14

use of Ecodes in pediatric and insurance outpatient resourses

  1. #1
    Location
    Traverse city/ Detroit
    Posts
    48
    Default use of Ecodes in pediatric and insurance outpatient resourses
    Medical Coding Books
    I would like to know how many of you use Ecodes in a pediatric office?
    i have been coding and billing injurys without the use of an Ecode i did ask about this and was told that the insurance companys dont care for it or dont pay.

    Just wondering how everyone else feels about this? and also med check 90805ADD pt insurance companys dont pay for that either so it has to be billed a different way. Where could i go find more information some insuance companys are BCBSM,PRIORITY HEALTH,MEDICAID,COFINTY.I always thought that the guildlines in the ICD9 & CPT were the ones to look at, but i guess i need to find what insurance companys also look for thanks in advance for any advice.

  2. #2
    Post
    Quote Originally Posted by geminitc81 View Post
    I would like to know how many of you use Ecodes in a pediatric office?
    i have been coding and billing injurys without the use of an Ecode i did ask about this and was told that the insurance companys dont care for it or dont pay.

    Just wondering how everyone else feels about this? and also med check 90805ADD pt insurance companys dont pay for that either so it has to be billed a different way. Where could i go find more information some insuance companys are BCBSM,PRIORITY HEALTH,MEDICAID,COFINTY.I always thought that the guildlines in the ICD9 & CPT were the ones to look at, but i guess i need to find what insurance companys also look for thanks in advance for any advice.
    Hi Geminitc81,

    That is normal for E codes to be omitted in the corporate methodology. I had the same thought back when working as a ………… I always heard and still do hear coders in the clinical setting saying there is only one way to code and that is according to the insurance company guidelines which is true to an extent; but if you follow that semi-coding unorthodox trend you will end up coding unethically and breaching the COE.

    So try your hardest to code according to the AHA, AMA, CMS guidelines while at the same time making the necessary adjustments to your code sequencing to get paid. Nothing makes me more upset when people abandon there morals in order to get paid;
    “No matter what profession a person is in”

  3. #3
    Location
    Traverse city/ Detroit
    Posts
    48
    Default
    Chad Malek

    Well said! Thank you so much for your advice that is exactly how i feel when Im coding. Im always worried weither or not Im coding correctly becuz of the insurance guildlines and what they want.
    But Im glad Im not the only one that feels that way Ive been on job for 3 months and i love it. The people are great and easy to talk too. Working hands on is different form what I was taught in class, but I will take your advice and try my best to code according to the AMA,CMS guildlines.

  4. #4
    Default
    This reminds me of my first job.

    Diagnosis Rule #1 : We don't use E Codes EVER

    Diagnosis Rule #2 : We don't use V codes unless we absolutely have to

    Anyone else been told that at least once?

  5. #5
    Location
    Traverse city/ Detroit
    Posts
    48
    Default
    LOL.....yea that was the frist thing that was mentioned we dont ever use Ecodes and the only Vcode we really use V20.2 for immms and physicals. Im just worried in the future if a consultant or someone in that nature comes and tells me "why do you code the way you code" as a CPC you should no better.
    So tell me do code now with Ecodes and Vcodes?
    and if so how did that happen?

  6. #6
    Default
    Well, I'm a consultant, and I don't code on daily basis for my full time job. I do however stay proficient in coding with a strong point in E/M. I do have other contracts where I independently code, which I do use E and V codes every time they are applicable. This is what we are taught, this is what the official ICD-9 guidelines say.

    I find in private practice, E codes are often, if not always, overlooked.

    I'd love to hear input from others on their use of E & V codes. If anyone audits for a payor, how do payors feel if these codes are or are not used? Do they ding the provider?

    Inquiring minds want to know

  7. #7
    Default
    It just seems like the Lazy approach to me if you are not coding correctly, just because it does not bring you extra reimbursement. I am in a pediatrics office and we use E-codes whenever appropriate. We see a lot of accidental injuries, vaccine reactions, etc... Compliance is a major issue now and cutting corners can only bring problems down the road. Now if I could just get the Knuckleheads up front to stop putting the E-code first...
    Barbara Haskins CPC

  8. #8
    Default
    ohh .. up front staff! gotta love 'em

  9. #9
    Location
    Kachina Coders
    Posts
    16
    Default E Codes
    We use E codes here where I am at but.... when I first started the data entry girl was told to use the E988.9 - unknown accident whenever the softwear prompted her to use an E code, she actually had a memo from the mgr on it- they still use the V20.2 with the immuz and so far unable to break them of that habit, unless they use the V05.9.

    It is hard being the only certified coder in an office w/ 10 billers. They still make me at times question myself and get me all topsy turvy, but we do have a new mgr who is open and less defensive so hopefully... but the questions they ask me......... I am glad this board is here, I am going to need all the help i can in the future w/ this place.

    Kat

  10. #10
    Default
    I say... Welcome to the world of a coder and stick to your guns... it gets exhausting sometimes listening to the office staff say "but that's how we've always done it"... ok folks... that does not make it right. Show them your documentation and don't back down.... ultimately being the only certified coder in the bunch you have the most to lose in an audit. I don't know what your official title is but mine comes with a little authority so I started issuing Memos when something needed to be changed. This way I have documentation that I informed them of the correct way to code things. Good Luck and you are right... this forum is a wonderful tool to use when you have questions.
    Barbara Haskins CPC

Page 1 of 2 12 LastLast

Similar Threads

  1. help ecodes
    By perkins05 in forum Diagnosis Coding
    Replies: 1
    Last Post: 11-08-2012, 10:22 AM
  2. Higher reimbursement for Ecodes???
    By Dicey in forum Billing/Reimbursement
    Replies: 1
    Last Post: 09-04-2012, 03:36 PM
  3. Ecodes for injuries
    By prallapalli in forum Diagnosis Coding
    Replies: 0
    Last Post: 11-15-2011, 09:38 AM
  4. Help with Ecodes
    By peanutbutterkisses in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 11-03-2011, 12:37 PM
  5. Pediatric Inpatient/Outpatient
    By broundy in forum Pediatrics
    Replies: 3
    Last Post: 11-18-2008, 06:40 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.