I would like to discuss a question I’ve received
several times over the past few months:
Question: Most of my
insurance companies no longer want to pay for ear irrigation for cerumen
impaction. What can I do?
Answer: We also have been having
problems getting paid for cerumen removal. Try this: document in the note that
the patient had "impacted cerumen" and that it was "manually removed" (like with
a curette) "by the physician". If it is done with an office visit, be sure and
put a 25 modifier on the office visit. If it is denied then appeal it with a
paper claim. If it is still denied then that means it is just their policy to
not pay for it.
Many people get denied this because of those above 3
requirements. It must be impacted cerumen and not just ear wax. It must
be manually removed and not just flushed out with water. And it must be
done by the provider, not the nurse.
We have received a very
positive response about our upcoming Advanced Coding Strategies Seminar.
Here are the details: It will be held on Saturday October 15th from 8:00am to
noon in Dallas at The Courtyard Dallas Central Expressway. The cost will be $250
and you are invited to come participate, or if unable you may order the audio
and video materials which will be available by October 25. We hope the positive
response will translate into a nice crowd at meeting time. We are utilizing a
smaller venue for this initial course and seating will be limited.
More
details will be available on the website and in the next few newsletters (the
course is available on our website now). This course is intended to be a part 2
or ‘graduate’ coding course. It is intended for those of you that have already
taken our basic Coding Growth Strategies course. We will give a simple
overview of coding and then dive in to the many challenging cases that we are
presented with in our typical daily practice. You’ve heard me say that “90% of
the time if you find out the level of Risk, you then know how to code for the
service.” This class goes in depth to the other 10% of the time.
One
thing I’m very excited about is the "Challenging Cases" section. All attendees
will be encouraged to submit 1-2 of their most difficult (or common) coding
challenges. These will be printed and distributed to the group then as a group
we will go through and pick them apart to see exactly the correct coding that
should be applied to the note. And as always, if anything was overlooked we will
definitely show where an additional piece of documentation could’ve made the
difference for a higher level of service.
Sign up for the
Advanced Coding Strategies live presentation
Pre-order the
Advanced Coding Strategies DVD/CD
(available October 25)