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leastham

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Patient had a knee scope for chondromalacia in Novemeber and patient came back to office in February because he had fallen on the ice and was having locking and swelling and pain on the same knee that he had Sx on. Health alliance is denying office visit saying it is bundled in the global period. I even added a 24 modifier to office visit. How can I get this claim paid?


any suggestions is helpful!
 
leastham said:
Patient had a knee scope for chondromalacia in Novemeber and patient came back to office in February because he had fallen on the ice and was having locking and swelling and pain on the same knee that he had Sx on. Health alliance is denying office visit saying it is bundled in the global period. I even added a 24 modifier to office visit. How can I get this claim paid?


any suggestions is helpful!
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di you submit the office note in an appeal with a letter and follow up? They'll need to see this a new injury on same knee.
 
It was chondromalacia for the surgery. I did use a injury code also along with two other diagnosis codes with the office visit and 24 modifier on office visit. The insurance is health alliance.

Lisa
 
you probably need an E code with the injury to indicate it is an acute injury, not sure but maybe.
 
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