Medical Coding- is there a list available online?

  1. Hi! I have a friend who recently had surgery. The hospital sent her a bill, which she sent to her insurance company. The bill was not itemized, and had no insurance codes on it, but instead had only a total cost. The insurance company said that without the codes they aren't paying a dime. The hospital said the insurance company doesn't need the codes and that the bill alone should be suffecient. So. Anyone know where these codes can be found? Is there a book at the library? Something on the internet? Anything? If you have any suggestions, I'm all ears. Thank you!!!

    Kristi
    •  
  2. 5 Comments

  3. by   CseMgr1
    Your friend needs to contact the Insurance Commissioner in your state. It is not HER or YOUR responsibility to obtain revenue codes, in order to get a bill paid! Whoever is doing claims review on the back end for her insurer, needs to get off their butts, pull out a coding book, code those procedures and shoot that claim through! I know this, because I work for a Managed Care Organization doing preservice reviews, and if the provider does not provide the revenue codes, then it is my responsibility to code that procedure! We are not even allowed to ask a provider for that information! That is ridiculous!

    Let us know the outcome, ok?
  4. by   purplemania
    sounds like poor communication somewhere. Hospitals usually send a codeless "statement of the account" to the pt and a coded "claim" (or bill, as we like to say) to the insurance company. Your friend needs to contact the hospital again, and write down name,date, etc. of everything said so as not to have misunderstandings. Good luck.
  5. by   renerian
    Hahahaha no codes on the insurance bill wow that is one I have not heard of. As a patient I have asked for itemized bills.

    renerian
  6. by   RN auditor
    I think the codes you are referring to are the CPT and ICD codes which designate procedures performed and diagnoses assigned. I am not surprised the insurance company won't pay for these without the codes. Contact the director of the billing department for this and if it doesn't work I would file a complaint with hospital administration.
  7. by   tonicareer
    Yep you need codes. It might be considered a bundled code as well. Send letters and call also. Yes you can find codes online.

close