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Wiki BCBS of NC and denials for Prophylactic

Thread starter Coastal Coder
Start date Feb 25, 2016

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Coastal Coder

Networker

Feb 25, 2016

Good Morning,I was wondering if anyone is having any luck getting paid for Prophylactic mastectomy when billed with mastectomy for Breast cancer in the other breast? If so what are you doing to get them paid? I'm using Dx code Z40.01. They are also denying appeals with notes and letter of Medical necessity. Thanks for your help.

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