A question asked at the recent presentation.
Insurance companies use medical coding to identify and detail a medical procedure. For example: if you are an Orthopaedic surgeon you will understand precisely what a Multiple arthroscopic operation on knee (including meniscectomy, chondroplasty, drilling or microfracture) is.
That is an awful lot to put on an invoice every time you produce one! Plus there may be variations on such a procedure.
The code W8500 will specifically identify the procedure. Put this code on the invoice instead.
Where do you find a CCSD code?
Codes can be located on the CCSD website: www.ccsd.org.uk
The Clinical Coding and Schedule Development Group (CCSD) consists of representatives from the five major healthcare insurers.
The CCSD Group’s purpose is to maintain a common standard of procedure codes. Codes that reflect medical practice within the independent healthcare sector and are freely available.
A CCSD code is imperative IF a surgical episode is required. The patient will need to quote the code to his or her insurance company when pre-authorisation is being requested anyway.
What fee can I charge for each code?
However, be warned.
The example above of W8500 will be recognized but a CCSD code does not come with a suggested fee. The rate for each code is up to the individual insurance company concerned. You need to contact each insurance company to discover what fee they will pay for a code.
When an invoice is sent to the insurance company for your fees, the code should appear on the invoice and will reconcile to that expected by the insurance company.
If you do NOT use CCSD codes payment will be substantially delayed if made at all!
BUT THE REALLY BAD NEWS IS????
Without a CCSD code, you will not be able to invoice electronically anyway!