General Category > General Questions
Assigning the right codes
RichardP:
--- Quote from: Scott on August 04, 2014, 02:14:05 PM ---... because the patients come over from all over the country.
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For Workers Comp?? That sounds like folks are leaving their state and coming to your provider's state. I didn't think Workers Comp crossed state lines. We do some, but not much, Workers Comp billing, so I am uninformed about this paying across state lines thing. Does that really happen?
Michele:
--- Quote from: Scott on August 04, 2014, 02:14:05 PM ---Thanks for helping. I am not being as clear as I should because I'm flying a little blind. Sorry about that. The services this doctor is providing are somewhat cutting edge and so I have to find similar codes. The closest related services I can come up with are EMG services. I ask about jurisdiction because the patients come over from all over the country.
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If they are cutting edge I would be careful that they are covered WC services. If they are not widely accepted services yet then they may not be covered. They may also not have CPT codes assigned yet, or they may have temporary codes. I am also confused as to patients crossing state lines for WC services.
--- Quote from: Scott on August 04, 2014, 02:14:05 PM ---Basically I was trying to determine a list of appropriate questions to ask a provider who's never billed these services before so I can appropriately assign codes. I know I am being way to vague and I'm sure I'm not asking the right questions (mostly because I'm new at coding). If you were going in to a knew client who wanted you to provide coding services so he can determine what he's going to be reimbursed, what types of questions are important. Maybe that's a better way to ask it.
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The best thing you can do is ask for a specific description of the services. Also, if the provider is using some form of equipment for the services the company that provides the equipment may also be able to provide codes.
Scott:
I appreciate everyone's input. It is very helpful. Crossing state lines for work comp treatment is somewhat common. An example is someone from NY moving to FL, but the injury occurred in NY. The provider typically has to follow the jurisdicational state's rules. In my particular case, the services are provided to athletes being treated by a specialist (the dr I'm trying to help) in another state.
I agree auth is important, esp in this case, although we're pretty good at good non-auth'd services collected.
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