Wiki 33225 denied

[coders_rock!]

Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me

 

[btadlock1]

Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me

Well, for one, you've got a discontinued procedure modifier on it - usually they want records for those. I can't see any other reason to deny it, though.

 

[dpeoples]

Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me

I agree with Brandi, the 53 modifier could be the issue. I also consider 36005 inherent to the procedure and not separately billable. Did the payor reimburse for 36005?

HTH