Wiki BUNDLED? 92014 & 92134?

[southbaycoder]

I'm having denials from a HMO group stating the CPT code (92134) is Mutually Exclusive procedures cannot be done on the same day/setting. Also "Procedure is incidental to primary procedure which is a (92014) Ophthalmology Consult. Any rendered help would be appreciated Thanks again...

 

[SharonCollachi]

Ask for the HMO provider manual and start there.

 

[Cheezum51]

You need to appeal and have this error corrected in their system. An OCT scan has NEVER been bundled within the 92014 comprehensive exam code.
I wonder if they're trying to say the OCT of the posterior pole is the same as the retinal exam element included in 92014. They are two very different things.

Also there isn't a CCI edit which prevents doing a 92014 and 92134 on the same date of service.

Tom Cheezum, OD, CPC, COPC

 

[TESSA2019]

Are those the only 2 codes you billed for that dos? I know you cant bill 92134 and 92133 together and you cant bill 92134 or 92133 with 92250 on the same day. I have nvr had 92014 and 92134 denied as bundled.