Wiki 97597 denial in Wound Care Facility

[asowder]

I have several claims that keep denying from WPS and state that another insurance should be billed. We are billing an office visit with a 25 modifier and 1 unit of 97597. POS is 22 and a physician is doing the service.

I am new to this billing and would appreciate any help that you can give me.


Anika

 

[kerrcm1]

if denial states another Insurance should be billed this might be a case of coordination of benefits, possible injury wc/auto, you might be billing secondary insurance. I would reach out to the patient and verify insurance information and rule out the listed possibilities.