WORKERS COMP IN MEDICAL BILLING: Workers Compensation denial reasons in denial management
A) If DX code is not related to injury :
Example: R0789- Related to Chest pain.
K5660- Related to Disease of intestines
- In this case, after confirmed that the billed DX code is
not related to the injury. We have to remove ‘yes’ mark from
“EMP status” & need to remove the “ACCIDENT DATES”.
ACTION : REBILL THE CLAIM to same payer.
B) If DX code is related to injury :
Example: S99912- Injury of left ankle and S39012A.
- In this case, after confirmed that the billed DX code is related
to injury only. Need to bill the claim to WORKERS COMP PAYER.
ACTION: BILLED TO WORKERS COMP INSUARNCE. (EX: State form, All state)
# AR in Healthcare : Medical billing
#workers compensation denial reasons
#WC Scenario denial management in medical billing
#what are common causes of injured workers disputing the level of benefits or compensation?
#what is workers' compensation insurance
#work related injury
# diagnosis not related to injury
# diagnosis related to injury
# Changes on EMP status on medical claim form CMS 1500
# accidental dates
# PR 19 /N418
# REBILL THE CORRECTED CLAIM OR CLONED CLAIM
# REBILLED TO WORKER COMP PAYER OR INSURANCE
# WC
# WORKERS COMP : Section 60 of the Workers Compensation Act 1987
# BASIC RCM : REVENUE CYCLE MANAGEMENT IN MEDICAL BILLING
# DATE OF SERVICE
# AR IN MEDICAL BILLING
#Accounts Receivable (AR)
#Accounts Receivable & Denial Management
