How to Appeal Orthopedic Surgical Coding Denials

Key Strategies to Handling Orthopedic Coding Denials

Event Information
Product Format
Prerecorded Event
Presenter(s)
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
Conference Date
Thu, Jul 27, 2017
Length
60 minutes
Product Description

Learn Effective Ways to Handle Orthopedic Surgical Coding Denials

 

No matter how hard coding staff and providers try to code appropriately for orthopedic surgical procedures, insurance carriers still deny claims.  In order to get your point across you need to know the most effective ways to appeal a surgical denial in order to give enough information for the insurance company to process the claim correctly and avoid additional denials and appeals.  There are a few common combinations of surgical procedures that insurance carriers will frequently deny incorrectly.

In this session, expert speaker Lynn Anderanin will look at those cases and discuss effective ways to fight them. Lynn will review sample appeals letters and documentation to use on insurance carrier appeals forms to get the point across for common denials in orthopedic surgery that are effective and apply coding rules and guidelines in the appropriate way.  She will also discuss bundling and unbundling issues and add on codes and what is expected as reimbursement on these codes.

Your office should always review denials for accuracy, and fight them when they have been made inappropriately. You should not assume that a denial is an automatic write off.  By knowing current coding rules and guidelines, and applying these to surgical claims you can maximize reimbursement, and explain to an insurance company when they apply these rules and guidelines wrong. You will receive current sample appeals to assist in these denials.

Session Highlights:

  • Are you receiving denials for knee arthroscopy?
  • What are the most recent rules and guidelines for Medicare and commercial carriers?
  • Laminectomy with combined arthrodesis: Why are we getting denials when the laminectomy is being performed for decompression?
  • Edit changes for shoulder arthroscopy:  Are you reporting services that were previously considered bundled, and missing out on maximum reimbursement?
  • Writing appeals that result in proper reimbursement for the most common denials in orthopedic surgery.  Are you spelling it all out?
  • Effective appeal examples for add on codes when insurance companies apply inappropriate discounts

Session Agenda

  • Common denial codes with examples
  • Bilateral procedures
  • Down-coding E/M services
  • NCCI policy manual
  • Laminectomy and combined fusion
  • Methods to capture denials
  • Quantify denials
  • Who can help
  • Appeals for correct reimbursement
  • Sample of appeal letters

Who Should Attend?

  • Orthopedic coders
  • Orthopedic billers
  • Collections
  • Managers
  • Physicians
  • Physician assistants
  • Nurse practitioners

At the Q&A session following the live event, ask a question and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-866-458-2965 Today

You can also order through:
Phone

1-866-458-2965

Fax

1-919-287-2643

About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
More Events By The Speaker

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