kcowan
Guest
submitted out claim to bcbs 31238 rt and 31231 rt, one problem rt shouldn't be on the 31231.
patient 9 year old seen in office for nasal allergies, enlarged adenoids, and recurrent nose bleeds, worse on left. Notes don't say if nose is actively bleeds so i would assume not bleeding. all that was done in office was exam no diagnostic endoscopy or treatment of nose bleed due to child being uncooperative. so patient was scheduled for out patient. by the way notes say left.
op notes state pt was sedated and intubated diagnostic nasal endoscopy was then performed using a 30 degree endoscope. the blood vessel was then identified along with nasal floor and it was cauterized under direct vision of endoscopy. right diagnostic nasal endoscopy was then carried out to evaluate for lesions causing chronic nasal congestion. no suspicious lesions or polyps identified.
insurance paid the 31238, but not the 31231. I don't feel that xu is appropriate because the scope is part of the main procedure. I know i need to file a corrected claim because of the noted indicate epistaxis on left side not right, no modifier should be on the 31231 unless xu for separate procedure i don't think is ppropriate.
patient 9 year old seen in office for nasal allergies, enlarged adenoids, and recurrent nose bleeds, worse on left. Notes don't say if nose is actively bleeds so i would assume not bleeding. all that was done in office was exam no diagnostic endoscopy or treatment of nose bleed due to child being uncooperative. so patient was scheduled for out patient. by the way notes say left.
op notes state pt was sedated and intubated diagnostic nasal endoscopy was then performed using a 30 degree endoscope. the blood vessel was then identified along with nasal floor and it was cauterized under direct vision of endoscopy. right diagnostic nasal endoscopy was then carried out to evaluate for lesions causing chronic nasal congestion. no suspicious lesions or polyps identified.
insurance paid the 31238, but not the 31231. I don't feel that xu is appropriate because the scope is part of the main procedure. I know i need to file a corrected claim because of the noted indicate epistaxis on left side not right, no modifier should be on the 31231 unless xu for separate procedure i don't think is ppropriate.