tci General Surgery Coding Alert - 2002 Issue 4

Facilitate Billing: Use Modifiers, Diagnosis Codes Properly

Thorough knowledge and use of modifiers and diagnosis codes are key to efficient billing and reimbursement, says Kathleen Mueller, RN, CPC, CCS-P, a general surgery coding and reimbursement specialist in Lenzburg, Ill.  "Carriers deny claims for a lot of different reasons," Mueller says, "but the majority of denials are the result of incorrect modifier use and the wrong ICD-9 code." You can improve coding by consulting physicians before negotiating with private payers, considering some private payers adhere to coding guidelines that differ substantially from guidelines listed in the Correct Coding Initiative (CCI), the Medicare Carriers Manual...

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