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Medical Billing For Breast Biopsies To Avoid Denials

Medical Billing For Breast Biopsies To Avoid Denials

Medical Billing For Breast Biopsies To Avoid Denials

When performing medical billing on a breast biopsy, it is necessary to follow correct protocol. Failure to do so could result in a returned claim or a denial of payment. The key to any question of medical necessity lies in the diagnosis code (ICD-9 code).

Many medical billers have gotten into the lazy habit of only using a 3 digit ICD-9 code. This is because the only payer who seemed to care what the diagnosis code was, happened to be Medicare. Now-a-days most payers require an accurate and complete diagnosis in order to pay a claim.

If you are doing medical billing for a breast biopsy, make sure the diagnosis code clearly reflects the reason why. Four and five digit codes will likely be paid as long as they are the most descriptive codes available. Three digit codes rarely get paid by insurance companies without a letter of medical necessity. To avoid this hassle and delay in payment, it is better to choose the most descriptive ICD-9 code to begin with.

The lazy practice of using three digit codes has effected medical billing offices in another way. Most of them don’t have the most up-to-date ICD-9 codes available. Their records have fallen behind because in the past it wasn’t necessary to use the correct medical billing codes.

It is beneficial for a medical practice to outsource their medical billing to a medical billing firm. This ensures correct and current ICD-9 code usage. It is their business to keep current on any changes that may take place. Let your practice worry about its patients, and let the medical billing company worry about new billing protocol. This way everyone wins.

In order to get claims paid in a timely manner, correct medical billing practices are necessary. Make sure your ICD-9 codes are up-to-date to avoid denied charges for procedures such as breast biopsies.

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