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Thursday, May 28, 2009

Everything's up-to-date in Kansas City

Last week, I received a call from a doctor's office inquiring why her claim for a B-12 injection might have been denied by a particular payer.  She indicated that they used Current Procedural Terminology (CPT) code 90772 to report the service. 

A quick check of my 2009 CPT book identified the problem.  Code 90772 has been deleted for 2009; the correct new code is 96372. 

It never ceases to amaze and amuse me when a physician's practice is not using the current versions of a CPT, Healthcare Common Procedure Coding System (HCPCS), or International Classification of Diseases, 9th Revision - Clinical Modification (ICD-9-CM) manual.  It does not take too many claims denied because of out-of-date codes to equal or exceed what it would have cost the practice to buy current copies of the necessary coding manuals.  Indeed, the ICD-9-CM manual is available on CD-ROM from the U.S. Government Printing Office for only $19.00, and HCPCS can be accessed freely on the Centers for Medicare and Medicaid Services web site (although I still prefer to use the manual version). 

So, take a moment right now, while you're thinking about it, and pull your CPT, HCPCS, and ICD-9-CM books off the shelf.  If they are not the most current versions (i.e., 2009, as I write this), then it's time to order new ones.  This ounce of prevention for denied and returned claims should more than equal the pound of cure found in resubmitting or appealing such claims. 

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The views expressed here do not necessarily reflect the opinion of FPM or the AAFP. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. See Terms of Use.