Here you’ll find some helpful coding resources to make coding easier.
Coding tip sheets and web tutorials
Premera’s suite of 15+ coding
tip sheets guide the user 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.
In addition, several brief coding
web tutorials are intended for clinician and coder audiences, and were
developed with busy clinicians in mind. Our virtual
care guides help identify how to capture and document physical exam
findings during a telehealth visit.
For more information on virtual care or
diagnostic coding, reach out to ProviderClinicalConsulting@premera.com.
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.