¶¶Òô´ó¹Ï members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ¶¶Òô´ó¹Ï member’s name and ID number. Only questions will be accepted and not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.
Question: Is there something (as a coder) that we can send on claims to avoid sequestration, reduction in federal payment?
Answer: Unfortunately, there isn’t anything a coder can add to a claim that will prevent the federal sequestration reduction. Sequestration is a mandatory, across-the-board cut to Medicare payments that are applied after claims are processed—it isn’t determined by coding or modifiers. Coders can make sure claims are submitted accurately and completely, sequestration is applied at the payment level by Medicare and cannot be avoided or overridden through coding.
The best course of action is to ensure claims are coded and billed correctly so that the full allowable amount is processed, but the sequestration reduction will still be applied on the payment side.