Medical Billing Forum
Billing => Facility Billing => : thatcuteblonde August 05, 2009, 02:20:31 PM
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Hi everyone! I'm trying to bill the facility fees for an MUA (Manipulation under anesthesia) rendered to a patient. I have the CPT codes for the procedure, however I am unsure as to the corresponding ICD-9 code to put in box 74 of the UB-04. Does anyone have any suggestions on where I might find a list of these codes and the corresponding revenue code? Thanks!
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the physician didnt give a dx?
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The diagnosis code, or at least the diagnosis, must come from the dr. If he doesn't have the ICD9 but gives you the verbal description, you can look it up at http://www.icd9coding1.com/flashcode/home.jsp
Michele
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To add,
The doctor needs to give you the dx. This is based on his documentation of the visit.
Th stange thing about all of this, we, as billers, need a dx to support the procedure performed. There are carrier policies and Medicare NCD/LCDs (national Carrier Decisions/local Carrier Decisions) that do list what dx that is medically necessary to pay the service performed and being billed. if the dx is nto one of those acceptable in the NCD/LCD/policy, we cant make one up so the service is paid.
Again, the dx has to support the service, for example if the provider gave you a claim to bill a 12001 and a dx of 786.50, this wouldnt be correct. In simple terms. the doctor wants you to bill a wound repair and says chest pain supports the wound repair. Thats not correct. the insuranc company claims edit would deny the claim. This is why, as billers, we dont code, but we have to have some basic knowledge of coding, so we can recognize something wrong and do the right thing to ensure the claim is 100% true, accurate, and correct.
The following link can help you with some revenue codes, but it is down at the moment.
http://www.hcpro.com/content/208881.cfm
A list of some evenue codes can be found in this free document. However, it is not linked to any APC.
https://www.bluecrossma.com/staticcontent/npi_docs/UB_04FormLocatorAppendices.pdf
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The diagnosis code, or at least the diagnosis, must come from the dr. If he doesn't have the ICD9 but gives you the verbal description, you can look it up at http://www.icd9coding1.com/flashcode/home.jsp
Michele
Hey Michelle, I use that often. Its a great resource to determine if the code is billable or non-billable
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