Radiology Coding: Simple Steps Keep The Cash Flowing For Unlisted Codes

By Author: Julia Rose
Total Articles: 89
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Your radiology claims get caught in the sticky web of denials, audits, and appeals - it's time you take a look at your practice, because your payments can be tied up for a long time. Reporting a claim for radiology coding with unlisted procedure codes can put you in a tight spot, but there are ways which can get you the reimbursement you deserve. Make unlisted codes and supporting documentations inseparable - and you should see an immediate jump in your reimbursements.


Situations, where you can avoid the use of unlisted codes in radiology coding, use only the listed codes that get you the reimbursement, but situations which demand the use of unlisted codes, follow these simple steps to ensure that your claims are not denied:


Never use a CPT code that only approximates the service the physicians provide. If you find no precise procedure or service codes, report the service using the most appropriate unlisted code.


When you submit an unlisted-procedure claim, add a manual claim on paper with ...
... the complete operative note and a cover letter that clearly explains what the physician did. Your objective should be to make the person on the other end understand, or else, your claim will be denied.


Add a short description of the unlisted service, and indicate that you've included supporting documentation.


Some payers require electronic claim as proof of timely filing. Do so, but also submit a paper claim and state that it's not a duplicate claim, but supports the electronic claim. Better still, fax the paper documentation, if the payer allows that. Indicate that you have faxed the supporting document.


There is no standard fee for unlisted codes; the insurance company decides on the payment - based on the documentation you provide.


Be on the look for radiology coding updates. A modifier might just make your life easier.


Last but not the least, pack in any extra information you feel is relevant in getting the reimbursement for your facility.


We also provide medical billing and medical coding audio conferences with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.