Insurance Coding Question

skidmarks

Filing Flight Plan
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Sep 3, 2012
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Skidmarks
For reasons that are unintentionally ironic with my username, (It's because I used to fly helicopters I swear) I was sent to get a flexible sigmoidoscopy. Everything turned out pretty much OK in that department except my dignity and now I take fiber supplements... but I recently received my "Explanation of Benefits" from Anthem and under the "Type Of Service" column, it says "Surgery - Abdominal."
I haven't flown in 5 years but probably will again in the future and I'm quite concerned about abdominal surgery being mentioned on my records anywhere, especially when it didn't happen. I've called the Dr. Office, their Billing Department, and the Organization that my employer uses to handle insurance. Anyway, nobody sounds all that confident about why it's billed as that but they're nonchalant and just think it's common to be coded that way because it's a procedure.
Does anyone have experience with this, should I be fighting this? If so, who am I even fighting? Our insurance is so convoluted that I wouldn't know where to start (for some reason unknown to me there is an organization in between myself and Anthem that provides/manages our plans and other confusing paperwork duties... I work for the State).
 
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Anthem BC is among the worst payors. So their docs are among the most aggressive coders. They don't nickel and dime the docs, they 1000 and thousand the docs.

Not much else to say. Just get a note from your doc saying it was a wellness colonoscopy. The end.
 
Not much else to say. Just get a note from your doc saying it was a wellness colonoscopy. The end.

Thank you, although I'm not sure I led you down the right path with the vague information I provided. It wasn't part of any wellness incentive or anything. I'm 28 and not even eligible for a wellness colonoscopy until 50 I beleive. I was sent for the sigmoidoscopy because of blood... which led to a diagnosis of hemmorhoids. I don't think the doctor could put that under wellness. I understand that I would have to report this if I were to go for medical cert again.
 
Well then, the note needs to say, "to investigate heme + stools, outcome of which was......... ".
 
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