With the majority of plastic surgery cases,
the surgeon knows in advance what the procedure
will be. With that in mind, it’s prudent
to write a pre-determination letter to
the insurance company with the CPT and
ICD-10 codes for the planned procedure.
There’s a difference between pre-authorization
(e.g., “Has the patient paid their premiums?”)
and pre-determination (e.g.,
“Assuming premiums are up-to-date, will
the proposed surgery and codes be covered?”).
ASPS cannot help with codes when
this necessary step has not been done.
We’ve attempted to include some key
requirements for frequent plastic surgery
procedures. The following are recommendations
of what to include in a high-quality op
note. By providing a good operative note,
you will hopefully be able to get paid for
what you do – and decrease the headaches
that can surround reimbursement.
Not for AMA PRA Category 1 Credits
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