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Unit 5 DB - The special report should include a detailed...

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Lorraine Huff Unit 5 Discussion Board September 27, 2009 “Special reports must accompany claims when an unusual, new, seldom used, unlisted, or Category III procedure is performed.” The use of these reports help the third party payer to verify the procedure and to make sure that it was necessary. If the report is not included then the insurance company could refuse to pay the claim due to lack of information. This would extend the amount of time it would take to render payment.
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Unformatted text preview: The special report should include a detailed description of the nature, extent, and need for the procedure. It should also include the time, effort, and equipment necessary for the service. These details are necessary so that the third party payer will not have to return the claim. References Buck, C. J. (2009). Step-By-Step Medical Coding. St. Louis, Missouri: Saunders Elsevier....
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