tci ED Coding & Reimbursement Alert - 2002 Issue 7

Medicare Versus CPT: Know the Coding Differences

ED practices may leave thousands of dollars on the table each year by applying Medicare coding regulations to all payers. CPT guidelines differ in several crucial areas, and coders who understand the differences can have a big impact on the bottom line. "Practices are absolutely losing revenue if they are not applying CPT rules when submitting claims to private payers," says Jim Blakeman, senior vice president for coding quality assurance with Healthcare Business Resources Inc., in Bala Cynwyd, Pa. "In addition, they are violating rules established to govern AMA coding." "This is an extremely important distinction,"...

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