tci Part B Insider - 2004 Issue 12

Part B Coading Coach: 3 Field-Tested Tips Improve Your "Unlisted-Procedure" Claims

Receiving fair reimbursement requires adequate  preparation and documentation If you've ever filed a claim using an unlisted-procedure code, you know how much effort is involved. To ensure that payers properly reward the physician's effort (and the coder's work in preparing the claim), our experts offer you three tips. Tip 1: Describe the Procedure in Plain English Anytime you file a claim using an unlisted-procedure code (for example, 37799, Unlisted procedure, vascular surgery; or 43999, Unlisted procedure, stomach), you must submit a full operative report to describe the procedure or service. Take note: If you're looking for fair reimbursement...

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