tci General Surgery Coding Alert - 2006 Issue 6

READER QUESTIONS: Paper Claim Doesn't Have to Mean Slow Filing

Question: We have difficulty filing paper claims for unlisted-procedure codes. Our payer says we are not in compliance with -timely filing- requirements. Do you have any suggestions?New York Subscriber Answer: Many payers require electronic claims as proof of timely filing. But on many occasions--such as when filing for unlisted-procedure code claims or modifier 22 (Unusual procedural services) and reduced or discontinued service (modifier 52 or 53) claims--you must provide full documentation and therefore file a paper claim.The solution is simple: File the claim electronically and then submit paper documentation separately. Be sure to include a note with...

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