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Hcs/304 Week 4

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Words 422
Pages 2
Healthcare Compliance
Assignment
Week 4

Write a one page document covering the Case Study found on page 43 answering the following questions.
Why is it important to use current codes and coding books?
How could this error have been prevented?
Would this claim have been denied?
What are some of the effects of a denied claim?

It's very important to use current codes and coding books. In this case study of Mrs. Cleett. If the Billing specialist hadn't checked the code before submitting the claim it could have been denied or delayed. Sometimes codes are revised and deleted. A new set of codes may tell you to code a different way. Using your coding books will keep you from over and under coding. It is also important to code from current coding books because the guidelines for a …show more content…
In the case of Mrs. Cleets case, the problem could have been prevented if the Assistant had code from the current coding book. The Assistant could have also let the billing and coding department do all the coding since they have the training to do the job. Mrs. Cleets claim would have been denied because the G001 code that was used no longer exist, the update code was 36415. The billing and coding specialist knows about all of the updates because they are aware of the different resources that are available to them. A denied medical claim can cause issues. If the claim is denied you will not get paid for the services performed. There is a time frame that you have to get claims submitted and if you don't get the claim in by that time frame then your employer lose money for that claim it is just like them giving service away for free. There are ways to prevent this from happening. Make sure your are coding

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