Getting Rid Of Denial Claims For Well Visits

You should always pay good attention to what payers are perceiving when looking at your medical billing. Even though your practice may view the coding procedures a certain way, it is not always the case that your payer will understand them in the same fashion. It has recently been shown that there is a major discrepancy when it comes to dealing with the billing of the procedure code 96110. The fact is that this procedure code should never be lumped in with well exam codes, except for special circumstances.

What can actually happen to cause problems is that the miscommunication between medical billing for your practice and the payers are that the payers and insurers are lumping two codes together at one time. While the bundling of codes can end up saving the payers money in the long run, this can cause problems for your practice. This is why the Centers for Medicare and Medicaid have been working diligently to help practices get reimbursed for the code 96110. By working on this, they will hopefully be able to show each individual state exactly how the process works to get this particular screening code reimbursed.

You can always take the initiative within your practice to make sure that payers are not able to deny payment for this code until further laws are in place. The best way to do this is to send them the appropriate information, including documents that can explain the 96110 separate billing process. Although it can be a long road when trying to get everything right in terms of medical billing, at least you will be doing the absolute best that you can when it comes payments and reimbursement.

View all Articles by: Melissa Clark, CCS-P