Medical Billing Forum

Coding => Coding => Topic started by: zakassam on February 18, 2013, 01:27:21 AM

Title: MRI - 73221
Post by: zakassam on February 18, 2013, 01:27:21 AM
I am new to coding and billing as i am filling in on short notice for the person who currently does this. We are billing out an MRI for bilateral wrists and the only codes that the referring physician has given me is pain in joints, and pain in joints multiple. My question is if i use these icd-9s, will this affect my reimbursement for billing. and also, do what modifiers might i need to use. I see before that they have used LT and RT ( left and right) but thats about it. Please let me know, appreciate the help in advance. Please include and tips and tricks that might help at your disposal!
Title: Re: MRI - 73221
Post by: PMRNC on February 18, 2013, 07:29:09 AM
You can't arbitrarily code or change codes to increase reimbursement that's fraud. If you are in doubt that the coding your provider has given you is incorrect I would suggest asking him to double check the medical record.
Title: Re: MRI - 73221
Post by: zakassam on February 18, 2013, 09:31:28 AM
My intention was never to change coding , my question was in general if diagnosis codes affect the reimbursement amounts? If so, then I will contact the referring physician for more details. Also we are an out of network facility. thank you for your response.
Title: Re: MRI - 73221
Post by: ruthie72 on February 18, 2013, 10:23:02 AM
 I would always query the physician for more details on the coding before sending out the claim.
Title: Re: MRI - 73221
Post by: PMRNC on February 18, 2013, 10:32:45 AM
Quote
My intention was never to change coding , my question was in general if diagnosis codes affect the reimbursement amounts?

All I can say is that yes, diagnosis codes as well as CPT codes and how they are pointed are vital to the reimbursement.  Your provider or a certified coder should be giving you the billing in the way it should be presented, if not you should contact them for clarification and if there is a need for a change you should document AND have the provider correct it and make a note for the chart as well.