“The hoops you have to get through vary by payer,” said Kim Pollock, RN, MBA, CPC, CMDP, a consultant with KarenZupko & Associates, Inc. in Chicago. “Some will routinely pay on an unlisted code that is used accurately. Others may not even recognize the unlisted code at all.”
Explore This IssueSeptember 2018
Get Preauthorization When Possible
It is recommended that you approach the payer to get a preauthorization if possible. This speeds up a process that may be slow under the best of circumstances. Even with preauthorization expect delays, as most require human intervention.
“The Academy has a manual for addressing these issues,” said Dr. Manes. “It can be found on the members-only part of the website at entnet.org. This is a very good resource.”
Kurt Ullman is a freelance medical writer based in Indiana.