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