It costs about $25 to resubmit a claim. Efficiency pays off!
Better performing practices provide physician training in ICD-9 and current procedural terminology (CPT) coding methods, including the importance of linkage. The diagnosis code (ICD-9) must agree with the procedure code (CPT) to support medical necessity.
Tip: Physicians are critical to preventing or correcting coding errors at the point of service rather than days or weeks after the claim is returned.
Increase physician understanding of coding by implementing physician-led coding and compliance programs. Appoint a physician and a staff person as the coding compliance team. The physician team member is responsible for providing feedback to other physicians in the group.
Tip: Conduct a periodic audit of patient charts and charge tickets. Increase physician understanding of coding through feedback on claims problems.
TMA offers the following help in improving coding and documentation in your practice.
TMA Practice Consulting can conduct periodic audits for your practice by carefully analyzing a representative sample of your practice's patient charts and corresponding explanations of benefits, claims, and fees. TMA's experienced consultants can identify problem areas, make recommendations for improvement, and provide on-site training for physicians and staff to help ensure you are receiving proper reimbursement for your services.
Content reviewed: 1/28/15
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