Key Strategies for Handling Orthopedic Coding Denials

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
60 minutes
Product Description

Determine if Your Claims Has Been Wrongly Denied and Learn How to Dispute Them


Due to all the work involved in the orthopedic office, denials are at the bottom of the list of priorities. That shouldn’t be the case; in fact, handling denials efficiently should be at the top of every practice’s list.

In this session, our expert speaker Lynn M Anderanin, CPC, CPPM, CPC-I, COSC will use her experience to share ideas and processes on how to manage orthopedic coding denials more efficiently. Insurance carriers hope that offices do not dispute denials because they are then paying less for claims and more profit. There is also urgency in reviewing and disputing invalid denials because most insurance carriers have timely filing limits on submitting an appeal, so it is critical that offices fit this process into daily practice tasks.

As insurance carriers create more policies and procedures related to coding, it can result in more claims denials for your office.  This session will review some common orthopedic denials as well as share ideas of how to handle denials more efficiently. Lynn will look at some common denials and determine if they are valid or not and will share samples of appeals for cases in which the insurance carrier should not have denied the claim. She will also discuss the use of reference material such as the AAOS Now and Orthopedic Coding Alert, and how they can assist in disputing denials.

Session Highlights:

  • Current trends in orthopedic denials currently being received by several practices and how to prove they are invalid.
  • Modifier 25- when is it appropriate and when can you not report a visit and procedure.
  • Utilizing CMS guidelines when insurance carriers are stating they are processing claims based on these guidelines.
  • Samples of what should be said for claims underpaid according to contracts and fee schedules.
  • Denials being seen for ICD-10 coding and how to avoid them in the future.

Lynn will also discuss:

  • Methods to Capture Denials
  • Quantifying Denials
  • Trends identified in Denials
  • Process for lack of documentation
  • ICD-10 Specific denial reasons
  • Sample appeal letter for contract compliance
  • Denial 97 bundling
  • NCCI tools for correct coding
  • NCCI Knee Arthroscopy 29876
  • 29877 vs. 29880/29881
  • Laminectomy and Combined Fusion
  • Sample appeal letter for add-on codes

Who should attend?

  • Orthopedic surgeons
  • Billers
  • Coders
  • Administrators
  • A/R staff
  • Managers
  • Collectors

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
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