O_KRECHKIVSKA
Contributor
Recently we got a lot of unpaid Medicare claims with CPT 69100. This code was billed to Medicare alone and some claims had office visits (with Mod-25) and Biopsy of external ear (69100). We received them with CARC CO-16 and RARC MA130, N822. I created Electronic Inquiry with NGS, received email from them that it is being worked and they will notify us by email when a response is available.
Does anybody else have this situation and what should I do? We didn't have this in past, it started as of last year (2024). It is a medical necessity to do this procedure and we don't code a general biopsy (11102, etc) instead of ear biopsy code (69100).
Does anybody else have this situation and what should I do? We didn't have this in past, it started as of last year (2024). It is a medical necessity to do this procedure and we don't code a general biopsy (11102, etc) instead of ear biopsy code (69100).