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tci Outpatient Facility Coding Alert - 2012 Issue 1

CPT® Coding: Unlock Your Spine Surgery Payment With These Documentation Keys

Payer rules keep changing, so keep up with what they want. Getting appropriate reimbursement for spine surgery has challenged physicians and coders for years, but recouping payment becomes even trickier when payers routinely change their own guidelines and policies. Your best defense is a good offense: Ensure surgeons thoroughly document each component up front to get the pay they deserve. Catch Up With Ever-Changing Guidelines Payers use different sets of guidelines for covering spine surgery, which means you must be familiar with each insurer's policies. Example: Some payer policies state that if there is no documented pain relief after...

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