tci General Surgery Coding Alert - 2022 Issue Q1

Compliance: Master These Appeals ‘Best Practices’ for Your Surgery Group

Focus the reason for your request. Being able to appeal claims that Medicare denies is a good thing. But avoiding appeals or making them count when you must file, is even better. Follow our experts’ tips to improve your chances of avoiding — or winning — appeals. Tip 1: Check Twice, Submit Once Before you file a Medicare claim, you should double check a few details that could lead to a denial. Coverage: All Medicare claims rely on documentation that the procedure is medically necessary, as evidenced by the diagnosis code in the claim. Some claims, such as screening...

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