Anesthesia Coding: Don't Submit Claims Based On Superbill

By Author: Julia Rose
Total Articles: 89
Comment this article

A physician circles his E/M code on the superbill after attending to a patient. But hold on, his job is not done as yet.


If you're submitting a claim based solely on the physician's writing on the superbill, think again. Doing so may well land you in a tight spot.


The fee slip is a communication tool between the physician and the front desk/coder/receptionist /support staff. It should not become part of the medical record; it should be kept in a separate financial record if that is accessible. In fact you should avoid coding directly from the superbill in all aspects of your practice, not just E/M.


One cannot deny the fact that coding directly from the superbill is faster in terms of productivity time and claims processing, but this type of coding is also fraught with errors and missed revenue. Watch out for the following:


If the superbill is not complete and out of date, there can be serious consequences.

If the person entering the data can't confirm procedures done, there might be incorrect claims.


Remember that ...
... superbills do not replace the anesthesia record. If billing personnel do not bill from anesthesia record based on the services actually documented, they are billing blindly.


What you should do instead: Make it a point to use the documentation to confirm that the physician selected the right code. If need be, discuss the discrepency with your physician to check if he forgot some documentation or forgot to put it in the chart. Do not downcode without lending an ear to your physician and letting him explain his reasoning.


For more anesthesia coding updates and ways to get your claims right, head to medical coding conferences and gain more insight.


Keep on updating your knowledge about anesthesiology coding by attending anesthesiology coding conference with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.