show me your codes and I'll show you mine

[PANDASmcnuggetsw/fry/coke]

On the phone, our carrier, which starts with a B and rhymes with SUE, said they would not even tell us the guidelines for ivig coverage unless we told them the procedure and diagnostic codes first. Now I have the codes and after reading some of the posts here, I'm not even sure if I should call them, but rather let the hospital handle it. I'm afraid they are going to to hold us to these codes even if doctor changes them.

 

What do y'all think?

Thanks,

PANDAS McNuggets w/fry/coke

[PANDASmcnuggetsw/fry/coke]

chirp chirp! feel free to PM me and not use your carrier name!

[peglem]

I'm not sure what codes are used to get my daughter's IVIG because it is all handled through the doc's office. But I think its coded for immune deficiency.

[Fixit]

On the phone, our carrier, which starts with a B and rhymes with SUE, said they would not even tell us the guidelines for ivig coverage unless we told them the procedure and diagnostic codes first. Now I have the codes and after reading some of the posts here, I'm not even sure if I should call them, but rather let the hospital handle it. I'm afraid they are going to to hold us to these codes even if doctor changes them.

 

What do y'all think?

Thanks,

PANDAS McNuggets w/fry/coke

 

 

mom md started a code list somewhere

[Worried_Dad]

Here's an old thread that might help: http://www.latitudes.org/forums/index.php?showtopic=6027

 

Now here's the bad news. We found out that hard way that - although the diagnosis codes don't change that often (as far as I know) - the procedure codes change every year. It's like a perverse guessing game between the service providers and the insurance companies: new codes are created each year, the old ones no longer work, the service providers have to try to figure out which codes are most likely to be covered for a given procedure, but the insurance company won't give them any hints because they don't want to cover them.

 

So we had IVIG 3 times in 2 different years. Codes that worked great for reimbursement the 1st time (although took 9 months to get any money back) were no longer valid, and the "new" codes were reimbursed at a much lower rate. Sigh...

 

Hate to repeat myself, but I really hate our healthcare system!!!