Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Hi Alon, I worked in insurance (coding, Compliance Officer, etc) for 18 years, 7 of them in 2 major teaching instutions). I now work part-time for a large acupuncture practice doing their insurance denial follow-up. Bottom line, you can't call a condition what it isn't. Period. That is fraud. On the other hand, if you use a code that is incomplete (meaning there aren't all of the digits there) that is not being specific. I'd be happy to email you off-list to help you with your coding issues. It's best to file a claim right the first time than have to go back and appeal later. Jean > >>>Well I do not know how much insurance work you do but I had several claims that came back demanding a higher (ie more specific) codes stating it is a HIPPA requirement. I never studies HIPPA but that is what the insurance companies have told me > alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 On the other hand, if you use a code that is incomplete (meaning there aren't all of the digits there) that is not being specific. I'd be happy to email you off-list to help you with your coding issues. It's best to file a claim right the first time than have to go back and appeal later. >>>>The denials I have got were for sprain strain/ back pain etc. ie 848.9; 724.5 etc. They requested a more specific code. Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 > >>>>The denials I have got were for sprain strain/ back pain etc. ie 848.9; 724.5 etc. They requested a more specific code. 848.9 = unspecified site of sprain/strain. so yes, the denial is correct, the body site you were treating is not specified. 847.x = sprain/stain back, the location of the back is what goes after the decimal (cervical, lumbar, etc) 724.5 is an incomplete code if that is what you are submitting. the codes are 724.51, 742.53, or 742.59 The code for back pain (no other dx assigned)724.5, low back pain is 724.2 The denials you received were correct based on the codes you gave above. Hope this helps. off to study for tonify yin herb test tomorrow..... Jean Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 The denials you received were correct based on the codes you gave above. Hope this helps. >>>>>>Thanks. Why did they say the more specific or higher code is a HIPA requirement? Alon Quote Link to comment Share on other sites More sharing options...
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