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billing colon & egd on separate dates for reimbursement reasons

Donya Posted Thu 27th of January, 2011 14:42:31 PM

My doctor has decided that he wants to do every procedure on separate dates for the reimbursement reasons. Is this insurance fraud?
Please any feed back would be appreciated.

SuperCoder Answered Thu 27th of January, 2011 21:15:50 PM

The documentation must justify the criteria why your physician has opted for a different session which could have been performed together. The documentation of reports should not contradict the concept of performing different procedures in different session.

Catherine Answered Fri 01st of April, 2011 12:45:42 PM

Be careful when a decision like this is made intentionally.

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