Here you’ll find some helpful coding resources to make coding easier.
Coding tip sheets
Premera has a
suite of coding tip sheets to guide you
while coding specific chronic or complex conditions and other particularly
tricky coding scenarios, such as coding cancers as historic vs. active, coding
immunodeficiency vs. immune disorders, and coding coagulation therapy vs.
defects. We also have virtual care guides to help you identify how to capture
and document physical exam findings during a telehealth visit.
information on virtual care or diagnostic coding, email ProviderClinicalConsulting@premera.com.
Coding major depressive disorder
Claims editor/What If tool user guide: Test professional billing scenarios and code combinations with our claims editing software that displays specific coding rationale.
Online secure tool
Claims editor/What If Tool (requires OneHealthPort log in)
Lists for denial edit codes
If you see a denial edit code on your Explanation of Payment (EOP), you can refer to our professional or facility lists of denial edit codes for details. Each list defines professional and facility claims edits on processed claims. These edits often result in reimbursement denial. Learning about the denial edit codes can help avoid future denials.
You can search for a specific payment policy or see the latest payment policy updates.
Note: Our payment policies are on a secure website and require a OneHealthPort log-in.