Using the proper ICD-9 code and the proper CPT code at the initial billing of a medical claim can guarantee and expedite payment to your office. Coding it right the first time keeps down mailing cost and employee time, and keeps aging claims from backing up in your accounts. Billing testosterone deficiency is no different from any other type of billing; you just have to be sure you have the information to substantiate billing for this reason.
Instructions
1. Obtain the patient encounter form and check for the procedures done and the diagnoses given by the provider. These may be either on a paper form or, if your office is paperless, this information can be found on the encounter section of your computer office-based software. Look at the patient's chart and encounter form and find out if the provider has listed "testosterone deficiency" as a diagnosis. Also look at all the procedure codes and diagnosis codes listed for that patient.
2. Take the ICD-9 code book and look up the diagnosis code for testosterone deficiency. You will see that there is no specific code for testosterone deficiency. The provider should have coded this as "testicular hypo function." Look up the codes for testicular hypo function and you will find that there are two different types of testicular hypo function listed--iatrogenic (meaning that it was caused by an outside source), which is code 257.1, or testicular (meaning that the testicles themselves are causing the hypo function), which is code 257.2. Look to see which code the provider has entered as the diagnosis. You can double-check this diagnosis by looking at recent labs or other reports. Enter this code in the proper section, which is section 21, of the CMS 1500 form to correspond with the procedure code that it supports.
3. Look in the patient's chart to confirm that the procedure(s) on the encounter form and the procedure(s) in the chart match. Look in the current CPT code book to confirm that the procedure code is correct and current. Enter the correct CPT(s) in the billing area of your medical software, or if the claim must be billed by paper, enter the CPT information in section 24 D of the CMS 1500 form.
4. Log onto your account with your medical billing clearinghouse and transfer the claim information for billing. If the claim must be filed by paper, print out the 1500 form and sign it in section 31. Place the form in an envelope and put it in the mail.
Tags: hypo function, 1500 form, encounter form, testicular hypo, testicular hypo function, testosterone deficiency, which code