rials he used, you might find 5 or 6 other "hidden" codes. Performing
comparison audits can uncover CPT codes that you otherwise would-
n't have billed. Each unbilled code you miss and don't bill for repre-
sents a lost opportunity, dollars that should have gone to your bottom
line.
The more specific, the better. When it comes to surgical docu-
mentation, specificity is your best friend. Learn the types of pro-
cedures your doctors are performing and know the proper codes
associated with those procedures. Make sure your docs know them,
too.
Let's use a retinal detachment case as an example. What type of reti-
nal detachment was it? What type of membrane was removed? If you
don't properly document those things, you need to ask follow-up ques-
tions, because the codes for each of those things are different — as
are the reimbursements.
As an example of omission, let's say an orthopedic surgery op report
mentions internal fixation, but there's nothing listed for fixation on
the surgeon's bill. It might be something as simple as a screw —
another $300, perhaps — that you'll find as a result of the audit. This
found money adds up quickly.
If performed well, a comparison audit can improve relations and
build solidarity between the surgical center, physicians and their
offices, as well as among all departments involved in the reimburse-
ment process. But it all begins with the surgeons practicing good doc-
umentation — and sometimes that can be a challenge. Physicians
tend to get used to doing things their way, which might include using
unspecified codes, and now here you are coming in and telling them,
"We need you to change." Those can be delicate conversations, but
there are certain ways to frame those discussions in which you can
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