Simplify your appeals process and achieve successful appeals
Our team specializes in medical necessity, documentation, and coding review. Hospitals and medical facilities trust us to draw upon individual experiences and leverage our client partnerships. Each of our specialists in our AppealMasters division has been actively involved in creating appeal templates to support specific audit appeals.
Every appeals template we’ve written is included as part of our Veracity™ Suite.
March 2015: Commercial Coding
Principal Diagnosis in Question
ICD-9-CM 196.5 (Secondary Neoplasm of inguinal region and lower limb lymph nodes) to ICD-9-CM 172.7 (Malignant melanoma of skin of lower limb, including hip)
The template includes a request for an appeal on PATIENT E’s denied claim for services at Hospital E.
The template includes comprehensive information on:
- Reasons of denial from the payer
- Substantiation of the ICD-9-CM codes that supports the proper DRG assignment
- Justification for the appeal
- Coding references
- Diagnostic and evidence based clinical references