generic808
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So the person before me in my position billed 20926 -50 (tissue graft) along with 19350 (nipple/areola recon bilateral). We got denied saying that "per physician fee schedule database, the 150% payment adjustment for bilateral procedures may not apply to procedure 20926 because of physiology/anatomy or because the code description specifically states that it is a unilateral procedure and there is an existing code for the bilateral procedure". There is no bilateral code for tissue graft so I'm thinking I should bill this 2 units? Any suggestions or opinions on this matter would be greatly appreciated. Thanks in advance.
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