CoreMedical
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Good morning,
I am new at Pain Billing. I have a CRNA only group that is charging for the Anethesia on injections. 01991 and 01992 are being billed with a QZ modifier. Humana Medicare is paying, however, the commercial product is not. Charge is being denied as "procedure/treatement is deemed experimental/investigational by the payer. When calls have been placed to Humana, two different representatives have advised if 01936 is billed it would be paid. Can this code be changed (legally)? Has anyone else experienced this denial? Have you appealed and received a positive result?
Thank you
I am new at Pain Billing. I have a CRNA only group that is charging for the Anethesia on injections. 01991 and 01992 are being billed with a QZ modifier. Humana Medicare is paying, however, the commercial product is not. Charge is being denied as "procedure/treatement is deemed experimental/investigational by the payer. When calls have been placed to Humana, two different representatives have advised if 01936 is billed it would be paid. Can this code be changed (legally)? Has anyone else experienced this denial? Have you appealed and received a positive result?
Thank you