Dana's Interview

Why did you choose to go into Medical Billing?

What is the difference between CPT and ICD9?

CPT – hospital settings and operative procedures
ICD9 – coding for physicians or anything that could be wrong with the patient (medical diagnosis)

What is the difference between ICD9 and ICD10 from your point of view?

ICD9 is the current system in place. ICD10 is more specific in coding, better statistical data for tracking trends in the medical industry. More codes are required which offer more specific drills.

Give an example of when you would use a HICPIC code vs. a CPT in medical billing?

HicPic is more dealing with supplies and equipment vs. CPT is used more for the actual procedure?
S codes are required government codes instead of office codes with Medicare

On your 1500 form, what box does your authorization code go in to?
Box 19?


What happens when a claim comes back. What are the two reasons for this to happen?

1. If it contains an error and is rejected
2. It can come back “denied”

What would you do if it was denied?

What would you do to obtain any funds we should be authorized?

I would check to see if it was a mistake made or I would file an appeal if I felt the denial was unfounded.

What steps would you take to appeal a denial?

First step is checking the claim against the records. Pull documents that support why it should be paid.
Fill out the form and get the doctor to sign off.

If you doctor submits over 50% of his claims under medicare than you will need to know the S codes.
Be more straightforward and to the point.

Top Qualities We Look for in our Employees
• We are looking for individuals who has a high rate of accepted claims.
• Correct denials/rejections within 24 hours of receiving them.
• Focus on learning all the new information on billing and coding as they change.
• You will be good at self-educating.

No comments:

Post a Comment