{"id":800,"date":"2013-08-28T10:11:10","date_gmt":"2013-08-28T10:11:10","guid":{"rendered":"http:\/\/www.medicalbillingstar.com\/blog\/?p=800"},"modified":"2017-02-14T07:24:15","modified_gmt":"2017-02-14T07:24:15","slug":"7-salubrious-coding-tactics-to-thwart-claim-denials","status":"publish","type":"post","link":"https:\/\/www.medicalbillingstar.com\/blog\/7-salubrious-coding-tactics-to-thwart-claim-denials\/","title":{"rendered":"7 Salubrious Coding Tactics to Thwart Claim Denials"},"content":{"rendered":"<p style=\"text-align: justify;\" align=\"center\"><a href=\"https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/08\/medicalcoding.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-801\" src=\"https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/08\/medicalcoding.png\" alt=\"medicalcoding\" width=\"728\" height=\"388\" srcset=\"https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/08\/medicalcoding.png 728w, https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/08\/medicalcoding-300x159.png 300w, https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/08\/medicalcoding-620x330.png 620w\" sizes=\"auto, (max-width: 728px) 100vw, 728px\" \/><\/a><\/p>\n<p style=\"text-align: justify;\" align=\"center\">Evolving code sets in varied coding systems (ICD-10-CM\/PCS, CPT-4, HCPCS Level II, etc.) are creating an intricate, but beneficial platform for the patient care, clinical documentation, data transfer, research, practice analysis and also repayment. <strong>Despite this pragmatism, quite a lot of physicians don\u2019t recognize <a title=\"ICD-10 Medical Coding\" href=\"https:\/\/www.medicalbillingstar.com\/icd-10\/index.html\">the significance of coding in clinical practice and its impact on reimbursement.<\/a><\/strong><\/p>\n<h2 style=\"text-align: justify;\"><span style=\"color: #ff6600;\"><b>The Tactics to Beat Around the Bush :<\/b><\/span><\/h2>\n<p style=\"text-align: justify;\">Beyond a shadow of a doubt, coding is the backbone of the practice business. <a title=\"Denial Management Services\" href=\"https:\/\/www.medicalbillingstar.com\/denial-management.html\">Improper medical coding cause claim denials<\/a>and culminate ultimately in revenue loss. Thus, it is imperative to address the hardships in medical coding with a fresh pair of eyes.<\/p>\n<p style=\"text-align: justify;\">\u00a0<b>1. <\/b><strong><span style=\"color: #ff6600;\">Update to Upsurge :<\/span><\/strong><b> <\/b>Once the new codes are released, every practice must <i>update<\/i> their encounter forms, super bills, user guidelines and <a title=\"Practice Management Services\" href=\"https:\/\/www.medicalbillingstar.com\/practice-management.html\">EHR\/PMS systems<\/a> with the fresh codes to create clean claims and to zero down the denials.<\/p>\n<p style=\"text-align: justify;\">\u00a0<b>2. <\/b><span style=\"color: #ff6600;\"><strong>Revise to Revive :<\/strong><\/span> <strong>During every \u2018updated codes\u2019 release, <i>revise<\/i> the corresponding fee schedule up-to-date, so as to improve your bottom line and to achieve compliance.<\/strong><\/p>\n<p style=\"text-align: justify;\"><b>\u00a0<\/b><b>3. <\/b><span style=\"color: #ff6600;\"><strong>Educate to Excel :<\/strong><\/span> Apart from updating the tools and systems, it is indispensable to <i>educate<\/i> the physician and the coders with the fresh and revised codes and the records desirable to make the codes evident.<\/p>\n<p style=\"text-align: justify;\"><b>\u00a0<\/b><b>4. <\/b><span style=\"color: #ff6600;\"><strong>Check to Cheer:<\/strong><\/span> Although, <a title=\"Claim Submission Processing Services\" href=\"https:\/\/www.medicalbillingstar.com\/electronic-claims-submission.html\">the claim scrubbers effectively validate claims<\/a> &#8211; by recognizing billing errors and creating edits to scrutinize denial issues \u2013 a manual <i>check<\/i> could ensure submission of clean claims. For example, the scrubbers may fail to validate the modifiers even though the software flags the claim as \u201cmodifier inappropriate\u201d.<\/p>\n<p style=\"text-align: justify;\">\u00a0<b>5. <\/b><span style=\"color: #ff6600;\"><strong>Review to Revamp : <\/strong><\/span>It is essential to <i>review<\/i> the new payment policies and coding guidelines constantly, to get acquainted with the payer\u2019s regulations.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #ff6600;\"><strong>A. CPT<sup>\u00ae\u00a0<\/sup>: <\/strong><\/span>The American Medical Association\u2019s (AMA\u2019s) revised CPT<sup>\u00ae<\/sup> codes can be effortlessly recognized. The green text in the CPT<sup>\u00ae<\/sup> code book highlights the modifications that are new to the revised book. Sometimes, the guidelines will modify or add supplementary information for proper codes although the codes remain unchanged.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #ff6600;\"><strong>B. NCD\/LCD<\/strong><\/span><b> : <\/b><strong>Medicare\u2019s National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) can be reviewed through the Centers for Medicare and Medicaid Services\u2019 (CMS\u2019) website<\/strong>. More to the point, the revised payment policies of private insurance companies can be reviewed through the payer\u2019s website. Reviewing the policies in this fashion aids the coders to &#8211; elucidate code use &#8211; spot the diagnoses that call for medical necessity &#8211; offer documentation requirements.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #ff6600;\"><strong>C. NCCI :<\/strong><\/span> The National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services can be reviewed to understand the bundling of codes. Supplementations and revisions to the policy manual have been italicized in red font in the electronic copy.<\/p>\n<p style=\"text-align: justify;\"><b>6. <\/b><span style=\"color: #ff6600;\"><strong>Designate to Delight :<\/strong><\/span> It is unfair that most physicians don\u2019t <i>designate<\/i> the primary diagnosis among an array of multiple diagnoses performed on the same patient. Furthermore, the physicians must number the diagnoses in the order of their significance so as to evade the denials based on \u2018medical necessity\u2019.<\/p>\n<p style=\"text-align: justify;\"><b>7.<\/b><span style=\"color: #ff6600;\"><strong> Invent to Infer : <\/strong><\/span>Following the aforesaid steps will assist you thwart claim denials associated with code revisions but will not eradicate them utterly, making \u201cdenial resolution\u201d obligatory. All the perfectly created codes would not get you the repayment. For instance, <strong>one of the new complex chronic care coordination (CCCC) code &#8211; 99488 is not reimbursed by Medicare as per its policy guidelines and thus it will be denied<\/strong>. But, on another edge, a secondary or other insurance payer may reimburse for this code. Thus, you need to <i>invent<\/i> a procedure so as to deduce the non-covered codes for every payer in your network.<\/p>\n<p style=\"text-align: justify;\"><b>To know more about the coding tactics or to clinch a deal !<\/b><\/p>\n<p style=\"text-align: justify;\"><b><\/b><b>Contact <\/b><strong>MedicalBillingStar @ 1-877-272-1572<\/strong><\/p>\n<!-- Begin Yuzo --><div class='yuzo_related_post style-1'  data-version='5.12.75'><!-- without result --><div class='yuzo_clearfixed yuzo__title yuzo__title'><h3>Related Post<\/h3><\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/www.medicalbillingstar.com\/blog\/the-hallmark-solutions-to-frequent-medical-coding-gaffes\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/09\/cloud-fluffy-lamb-150x150.png') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">The Hallmark Solutions To Frequent Medical Coding ...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/www.medicalbillingstar.com\/blog\/telemedicine-can-cash-cow-hospital\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2014\/08\/Telemedicine-150x150.png') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">How telemedicine can be a cash cow for your hospit...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/www.medicalbillingstar.com\/blog\/infographics-fdas-final-canon-on-healthcare-mobile-software-apps\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2013\/10\/FDA-Mobile-Apps1-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Infographics: FDA\u2019s Final Canon on Healthcare Mobi...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/www.medicalbillingstar.com\/blog\/will-accountable-care-organizations-pave-the-way-for-change\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2012\/11\/ACO-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Will Accountable Care Organizations Pave the Way f...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/www.medicalbillingstar.com\/blog\/compliance-thresholds-and-reimbursement-cuts-how-can-radiologists-survive-2013\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/www.medicalbillingstar.com\/blog\/wp-content\/uploads\/2012\/11\/radio-150x150.png') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Compliance Thresholds and Reimbursement cuts. 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Despite this pragmatism, quite a lot of physicians don\u2019t recognize the significance of coding in clinical practice and its impact on [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":801,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[137],"tags":[230,232,25,231],"class_list":{"0":"post-800","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medical-coding","8":"tag-claims-submission-services","9":"tag-denial-management-services","10":"tag-icd-10-medical-coding-services","11":"tag-practice-management-system","12":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>7 Salubrious Coding 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