To Avoid Fraud, Revenue Loss Coders Must Follow CPT Guidelines

Coders must follow certain coding rules in addition to supplying the correct current procedural terminology code for the procedure, according to Physicians Practice.

Advertisement

For procedures that can be reported in various correct ways, such as bilateral procedures, the best way to code would be to follow your payors’ preferences, according to the report. HIPAA mandates payors and providers give the same codes.

Other coding guidelines exist within the CPT code book, such as rules for how to record a simple closure of a malignant excision compared with an intermediate or complex closure. Improperly following rules could lose money for your surgery center or increase risk of fraud. Such rules can be found in the CPT code book as well as on payor websites and in provider manuals.

More Articles on Coding, Billing and Collections:
6 Basic Ways to Boost Healthcare Coder Productivity
Fee Schedules Vary Based on Technical, Professional Resources
Which Payors Do Physicians Prefer? 20 Statistics

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.