Your Source For Pediatric News and Community.
"Just Pain, No Gain"
Nov
12
Insurance companies lately have been denying "ear pain" diagnosistic codes for
the ear pain without infection. Any recommendations?
Also, insurance companies are very particular about paying for strep tests for
any diagnosis other than pharyngitis related codes. So, does that mean
that we need to "create" a pharyngitis for every kid with presumed "rectal
strep" or fever with HA and abd pain?
Any thoughts?
Eddie Salzberg, MD
www.roswellpediatrics.com
- Login to post comments
- Printer-friendly version
- 5 comments
"Just Pain, No Gain"
We don't have that problem. I know we bill abdominal pain, etc. with strep
tests. What particular carriers are rejecting? I would fight them!
----- Original Message -----
From: "Salzberg, MD"
To:
Sent: Wednesday, November 12, 2003 3:52 PM
Subject: "Just Pain, No Gain"
> Insurance companies lately have been denying "ear pain" diagnosistic codes
for
> the ear pain without infection. Any recommendations?
>
> Also, insurance companies are very particular about paying for strep tests
for
> any diagnosis other than pharyngitis related codes. So, does that mean
> that we need to "create" a pharyngitis for every kid with presumed "rectal
> strep" or fever with HA and abd pain?
>
> Any thoughts?
>
> Eddie Salzberg, MD
> www.roswellpediatrics.com
>
> This message is from PEDTALK - a Pediatric Focused email discussion
group.
>
>
"Just Pain, No Gain"
I'm not sure what rapid streps you are using, but the ones we use (sorry,
can't remember the brand name right now at home) specifically states that it
may only be used with throat swabbing...not other sites. So, it cannot be
used for rectal strep dx. I am not sure if all tests follow this or not.
Karen Kohlruss RN BSN
Holland Pediatrics
"Just Pain, No Gain"
Salzberg, MD wrote:
>Insurance companies lately have been denying "ear pain" diagnosistic codes for
>the ear pain without infection. Any recommendations?
>
>Also, insurance companies are very particular about paying for strep tests for
>any diagnosis other than pharyngitis related codes. So, does that mean
>that we need to "create" a pharyngitis for every kid with presumed "rectal
>strep" or fever with HA and abd pain?
>
I've got an even more assinine insurance qwerk. UnitedHealthcare is
instituting higher copays for patients who visit specialists. They want
me to sign an attestation that "my specialty designation of Pediatrics
is NOT correct" and that I am a "primary physician." Screw that!
--
Gary M. on LI
Disclaimer: Eh, never mind!
"Just Pain, No Gain"
No Problem.
Mark out the word "NOT" and sign the thing! Play with them - they won't know
what to do with the piece of paper!
-gb
----- Original Message -----
From: "Gary Mirkin"
To: "Peds Talk"
Sent: Wednesday, November 12, 2003 11:57 PM
Subject: Re: "Just Pain, No Gain"
> Salzberg, MD wrote:
>
> >Insurance companies lately have been denying "ear pain" diagnosistic
codes for
> >the ear pain without infection. Any recommendations?
> >
> >Also, insurance companies are very particular about paying for strep
tests for
> >any diagnosis other than pharyngitis related codes. So, does that
mean
> >that we need to "create" a pharyngitis for every kid with presumed
"rectal
> >strep" or fever with HA and abd pain?
> >
> I've got an even more assinine insurance qwerk. UnitedHealthcare is
> instituting higher copays for patients who visit specialists. They want
> me to sign an attestation that "my specialty designation of Pediatrics
> is NOT correct" and that I am a "primary physician." Screw that!
>
> --
> Gary M. on LI
> Disclaimer: Eh, never mind!
>
> This message is from PEDTALK - a Pediatric Focused email discussion
group.
>
>
"Just Pain, No Gain"
On Thu, 13 Nov 2003 23:22:09 -0500 "Graham" wrote:
>No Problem.
>Mark out the word "NOT" and sign the thing! Play with them - they won't
know
>what to do with the piece of paper!
That's exactly what I did!
Gary M. on Treo!