Answer:
There are a few reasons why you might need to change the codes on a claim. First, if the codes are incorrect, the claim may be denied. Second, if the codes are not up-to-date, the claim may be paid at a lower rate. Third, if the codes are not specific enough, the claim may be denied because the payer cannot determine what services were provided.
Here are some specific examples of when you might need to change the codes on a claim:
If the patient's insurance company has changed their coding guidelines, you will need to update the codes on the claim to match the new guidelines.
If the patient had a procedure that is not covered by the insurance company, you will need to change the codes on the claim to reflect a procedure that is covered.
If the patient had a procedure that was performed by a different provider, you will need to change the codes on the claim to reflect the provider who actually performed the procedure.
If you are not sure whether or not you need to change the codes on a claim, you should always consult with your supervisor or a medical biller.
Step-by-step explanation:
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