Posted by DickR (148.74.251.191) on March 07, 2001 at 10:36:35:
In Reply to: Dick, we could really benefit from your... posted by Bennie Sue on March 07, 2001 at 08:53:17:
Bennie Sue,
Here is the process on how a code becomes a code. From the information in the article it would seem that a request must be submitted to the panel and they will determine whether to add it.
Understand, IF a code were added you would not be assured that the Doctor would use the correct code for CH. Let's say we get the code and there is another denial of service. You still have to do what John is doing, go through the process of proving the service is needed and medically approved for that service. I do not have any experience with HMOs, just Standard Medical, Major/Medical and PPOs. So I can't offer much in the HMO field.
I do think getting a specific code would be good, BUT adding information to OUCH about how coding is done and informing people about the necessity of pursuing a rejected service would be vital.
Regards,
Dick