Using V58.3 Correctly In Your Medical Billing

Using V58.3 Correctly In Your Medical Billing

Using code V58.3 in medical billing should be used with care. Beginning on October 6, 2005 the Regional home health intermediary conducted a review of all claims submitted with this code. V58.3 means attention to surgical dressings and sutures. Soon this medical billing code will be closely scrutinized for medical necessity.

Now a days, the Centers for Medicare & Medicaid Services closely examines each and every claim that comes through their department. Over billing and fraud have become so prevalent, that they must keep a close eye on these medical billing practices. One of the codes they have decided to crack down on is the V58.3. No longer will this medical billing code be paid if medical necessity isn’t clearly established.

There are a few ways you can prevent medical billing denials from occurring. One way is to keep detailed medical records and report them with each medical billing claim you submit. This will show on each claim that the V58.3 was necessary for medical reasons. This, however, can be a long, drawn out medical billing process.

Another way to prevent V58.3 medical billing denials is to hire an experienced medical billing firm to handle your claim responsibilities. They are trained to know if extra documentation will be needed for a certain claim, or if the medical billing codes are sufficient for payment. They are also skilled in detecting errors before claims are submitted to payers. This will cut down on claim processing time and improve reimbursement rates for your medical practice.

Every medical service provided to a patient should be due to medical necessity. Unfortunately, not all practices follow this rule. That is why it is necessary to provide documentation of medical necessity with your medical billing for claims with the code V58.3

View all Articles by: Melissa Clark, CCS-P