Otolaryngology Coding Alert
There's No Need to Remove PQRS Codes from Secondary Insurer's Claim
Question: If we submit G codes (PQRS codes) to a patient’s primary insurer, should we remove the G codes from the claim before sending it to the secondary insurance? We have gotten a few denials from secondary insurance carriers on claims with the G codes listed on them.
New Mexico Subscriber
Answer: You can remove the PQRS code(S) from your claim, but that shouldn’t be necessary for payment. The secondary insurance often will just disregard the PQRS codes and deny them as non-covered and process the primary procedure code. If the secondary insurance company is denying the whole claim, then you may want to remove the codes prior to submitting the claim. Your clearinghouse should allow you to remove the codes before they are sent out.
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