Medicare Compliance & Reimbursement - 2011 Issue 1
Reader Question: Mind New CPT Sets for US Service
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Article Overview
This short article is a coding Q&A for revenue cycle and medical coding professionals that explains a claim denial involving an extremity ultrasound service in the context of a CPT code set change. It highlights how a deleted code can affect claim processing and why checking the service date and current CPT set matters when reviewing denials and resubmissions.
Why This Topic Matters
It helps coders and billing staff recognize that denials may stem from code-set updates rather than clinical or payer issues, prompting a review of the current CPT code set before resubmitting a claim.
What You Will Learn
- How a claim denial can be related to an outdated CPT code
- Why service date review matters when evaluating a denial
- How CPT code-set changes can affect ultrasound-related claims
- General considerations for resubmitting a denied claim
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Radiology coding professionals
- Emergency department coding staff
Codes Discussed
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