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incidental

K
Wiki INCIDENTAL DENIALS

THIS MAY BE A DUMB QUESTION BUT HERE IT GOES I HAVE BEEN GETTING DENIALS LATELY THAT ARE (N19) PROCEDURE CODE INCIDENTAL TO PRIMARY PROCEDURE. AETNA MEDICARE INSURANCE, THIS CLAIM IN PARTICULAR IS A E/M WITH MODIFIER 25, WITH 69210 OVER HAS BEEN PAID BUT NOT THE 69210, FOR ME TO APPEAL THIS...
- kcowan
- Thread
- Mar 7, 2023
- appeals denials incidental
- Replies: 3
- Forum: Auditing General Discussion
M
Wiki Can a modifier be added at the request of the insurer even if CMS/AMA guidelines don't require one?

We have some CPTs that have been denied by an insurance company for "missing modifier". CPT 99291 was paid then the payment was recouped as "within global period". After our appeal, we received a letter that stated "the claim submitted did not have a modifier appended to the E/M service"...
- mcochran
- Thread
- Feb 20, 2020
- auditing incidental legal modifier mutually exclusive ncci
- Replies: 2
- Forum: Modifiers
F
Wiki Incidental carpal tunnel release?

We had a patient with flexor tenosynovitis in the operating suite for I&D of flexor tendon sheaths. During the procedure, the physician performed a carpal tunnel release "to get to the flexor pollicis longus". Can I code and bill for the carpal tunnel release, or would it be considered...
- fltbaroque
- Thread
- Jan 24, 2018
- carpal tunnel flexor tendon incidental tenosynovitis
- Replies: 2
- Forum: Orthopaedics

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