Re: Coding question

From: D. Ashley Hill, MD (noemails@home.please)
Wed Nov 1 18:09:09 2000


At Wed, 1 Nov 2000, Brickster0@aol.com wrote:

>Kevin
>
>You'll never get away with the myomectomy. Don't file electronically. Send
>the paper claim with op note including anesthesia record documenting the time
>of surgery. I would double the charge and hope to get 40%more.

Good advice. The key is a detailed op note. If it is rejected, write and ask for the medical director or gynecology reviewer to examine the claim. If I were an HMO reviewer here is how I would handle this:

"Some are easy, some are hard. This one was hard. No way I'm paying for the myomectomy (it's bundled in to the TAH according to the feds, anyway), but I'll pay you the -22 additional amount."

Have a good one,

Ashley

--
D. Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, Florida




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