jenkins62
Contributor
HUMANA DENIED MY CLAIM ![Eek! :eek: :eek:](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
HELP!
I BILLED CPT CODE 27496 (Decompression fasciotomy, thigh and/or knee I compartment)
with ICD 9 CODE 958.92 (Traumatic compartment syndrome of lower extremity)
*1st DENIAL WAS BECAUSE THE ICD 9 CODE DID NOT MATCH THE CPT CODE/I SENT CODING COMPANION FOR ORTHOPAEDICS PAGE STATING THEY MATCH, APPEAL LETTER, OP-NOTE ECT.
*2ND DENIAL WAS BECAUSE MEDICAL RECORDS SUBMITTED DO NOT SUPPORT THE DIAGNOSIS AND PROCEDURE THAT WERE DONE. THIS SERVICE WAS NOT COVERED AS IT WAS NOT MEDICALLY NECESSARY. THEREFORE, DENIAL OF PAYMENT
WHAT DO I DO? ASK DOCTOR TO DICTATE LETTER?
HAS ANYONE ELSE HAD THIS PROBLEM? HOW CAN I GET IT PAID?
OP-NOTE
DIAGNOSIS: LEFT LOWER LEG EXCERCISE INDUCED COMPARTMENT SYNDROME
PROCEDURE PERFORMED: LEFT LOWER LEG ANTERIOR FASCIOTOMY AND LEFT LOWER LEG LATERAL FASCIOTOMY
I BILLED 27496 W/ 958.92 ****WAS THIS CORRECT?![Confused :confused: :confused:](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
HELP!
I BILLED CPT CODE 27496 (Decompression fasciotomy, thigh and/or knee I compartment)
with ICD 9 CODE 958.92 (Traumatic compartment syndrome of lower extremity)
*1st DENIAL WAS BECAUSE THE ICD 9 CODE DID NOT MATCH THE CPT CODE/I SENT CODING COMPANION FOR ORTHOPAEDICS PAGE STATING THEY MATCH, APPEAL LETTER, OP-NOTE ECT.
*2ND DENIAL WAS BECAUSE MEDICAL RECORDS SUBMITTED DO NOT SUPPORT THE DIAGNOSIS AND PROCEDURE THAT WERE DONE. THIS SERVICE WAS NOT COVERED AS IT WAS NOT MEDICALLY NECESSARY. THEREFORE, DENIAL OF PAYMENT
WHAT DO I DO? ASK DOCTOR TO DICTATE LETTER?
HAS ANYONE ELSE HAD THIS PROBLEM? HOW CAN I GET IT PAID?
OP-NOTE
DIAGNOSIS: LEFT LOWER LEG EXCERCISE INDUCED COMPARTMENT SYNDROME
PROCEDURE PERFORMED: LEFT LOWER LEG ANTERIOR FASCIOTOMY AND LEFT LOWER LEG LATERAL FASCIOTOMY
I BILLED 27496 W/ 958.92 ****WAS THIS CORRECT?
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