Sunday, November 30, 2003

Getting paid for junk codes
with Peggy Walker

Q. I have to bill electronicly, but I do not have enough room in the HAO (narrative field) to give all the information required to get paid for repairs and junk/NOC codes. (NOC or junk codes are for items that do not have a specific HCPCS code and require additional documentation.) How do we get items paid for the first time?

A. If you continue to have frequent denials because of lack of space to relay information needed to properly pay your claim electronic then go hard copy the first time. If you are doing high-end rehab or any type of base codes that require K0108s, E1399s or other “junk” codes, than split the claim. This is not ideal because we all want to bill electronic, but it is the best way to save you some time and effort and still get some money back quicker. Bill all items which have HCPCs codes electronic. If billed correctly and not denied for same/similar these will go straight through and you will receive payment. Then, bill the K0108 codes hard copy with all information required making sure you have the patient’s name, Medicare number and date of service on every page. The information needs to be concise and complete. The reviewers need the name, make, model and MSRP, as well as why an already coded item will not meet the patient’s needs.

Peggy Walker, RN, Billing & Reimbursement Advisor for U.S. Rehab/VGM. Reach her at (803) 754-2090.