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Saturday, April 9, 2011

SUBMISSION OF ALL THE REPORTED ICDs FOR CAPITATED PATIENTS

DESCRIPTION OF THE ISSUE
Per coding dept’s advice we initially billed only 4 ICDs(with higher specificity), though the progress notes contained more than 4 ICDs.

CONCEPT
IPA complained that claims were not filed with appropriate ICDs.  And they requested us to submit all the claims with complete ICDs for further go.

SOLUTION
We started billing all the left over ICDs through a separate claim with the concerned E/M codes of value $0.01.  After submission of these claims we adjusted the same since they were under capitation.

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