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The Importance of a Coding Cheat Sheet at Your Medical Practice


If you see more than eight patients per day, it is time you have a quick coding reference guide to maximize reimbursements based upon insurance and CPT codes.

Often, people get into habits and comfort zones in life. It could be eating the same cereal every morning, shopping at the same stores, or running the same course on your morning workout. Is it possible that these types of habits roll over into your business life? The answer is most definitely, YES. It happens in every industry, and sometimes you could just be going through the motions during the day not even noticing this is happening.

These patterns cost you valuable money but how can you avoid this costly pitfall? Create a quick reference guide for your coding. It sounds a little too simple, but you would be surprised at how useful this will be. Here how to start:

1. Pull out your medical practice's fee schedule and take a look at your common codes. Each insurance pays these codes differently based upon your contracts. Some insurance never pay your favorite codes. It is the first critical step in understanding why you have large adjustments versus payments at the end of each month.

2. Once you know what insurance pays which codes, it is time to investigate a little further. Are there other codes that you can substitute for ones that are not being paid by specific insurances? Here's the thing: insurance companies track very closely how much they pay and how often for specific codes. Is there a chance that the procedure or service you are providing can be covered under a lesser known code not landing on the insurance companies' radar? Take the time and look it up.

3. Are you performing services on patients that you had no idea there was a code for? I've recently come across one for rehab facilities. It's a taping code for anyone from a professional athlete to a Medicare patient with knee pain. Most insurance companies pay this code, and they pay it well. Who knew that all of those taping services that were just complimentary can actually be paid!

4. Do you know the codes you use that are timed and untimed? Untimed codes, like the taping one mentioned above can be used during the hour the patient is there getting other timed code treatments done. So think of it like this: You see the patient for an hour, you use four, 15-minute codes, and one untimed code, and immediately, you've added inflow to your visit.

Take it one insurance company at a time, and pick a star employee in your office to help you monitor these types of coding changes. Look at one payer each month, and then have that employee put together a quick reference guide based upon the results of how insurance companies are paying on new codes, old codes, cascading codes, timed and untimed codes, etc. What you will end up with is a great tool for your treating staff. This will also help educate them, and help out your billing department. This can only be a win-win situation.

It's all about education, patience, and opportunity to bring in more inflow into your medical practice. It's a small investment of time to reap huge results. Give it a try!

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