Competitors and coding experts were recommending incorrect codes for our client’s biologic and similar products that were being billed with an unlisted J code. Additionally, providers who participated in Coding Blogs and writers for Coding Newsletters for this industry were resistant to our client’s Billing Guide and The Global Integrated Reimbursement Services (GIRS) InContact Reimbursement Line® guidance to accounts on the appropriate codes.
This situation was critical to address, as the use of incorrect codes could have led to an increased risk of audits for the providers. The President of GIRS met with the American Medical Association (AMA) staff and requested authoritative coding guidance be published on the codes to educate providers. GIRS also met with the Coding Newsletter Editor and educated them on the appropriate codes for billing.
Accounts were consistently educated on the appropriate codes and the AMA guidance was provided to accounts through the InContact Reimbursement Line. To clarify the coding, the AMA staff themselves drafted a coding application for a specific Current Procedural Terminology (CPT®) code for the technology.
The GIRS President developed specialty society support and then presented to the CPT® Editorial Panel on the coding change. A specific code was assigned and this has significantly reduced provider confusion. This is an example of how GIRS integrates medical technology hotline work with reimbursement consulting services to achieve better outcomes for our clients. The issues reported on the hotline are considered by our client and us, which leads to reimbursement strategies being developed proactively to address the issues.
If you need the support of our InContact Reimbursement Line® to assist your accounts to submit clean claims and overcome denials, please contact us by email or call us toll-free at 1-844-514-4477 .