Hi Fellows,
I am fighting this claim with Blue Cross and they are denying my codes. Here is the scenario:
At this point, there was a significant deficiency of tissue in the floor of the nostril, and it was necessary to harvest a composite graft from the right ear. The ear had been checked and with 4 cc of 1% Xylocaine with epinephrine 1:100,000. A graft measuring approximately 14x5 mm was then harvested from the upper conchal bowl and this was removed. The skin was undermined on either side and then 4-0 chromic was used to close the donor site defect. Once this was done, then the composite graft was sutured in the floor of the vestibule to maximize the airway and prevent the transverse scar band contracture. It was sutured at approximately 10 points. Once this was done, then a conchal ear cartilage graft was harvested from the posterior side of the right ear. This measured approximately 12x3 mm. It was placed into the rim of the nostril and sutured into place.
I am coding this with 15760 and 21235. Please correct me if I'm wrong. They are rolling up the code 21235 to 15760 which I donot agree since these 2 grafts were harvested with different incisions and closure. They only paid us for 15760 and now I am appealing the 21235 to be paid separately.
Thank you for your feedback.
I am fighting this claim with Blue Cross and they are denying my codes. Here is the scenario:
At this point, there was a significant deficiency of tissue in the floor of the nostril, and it was necessary to harvest a composite graft from the right ear. The ear had been checked and with 4 cc of 1% Xylocaine with epinephrine 1:100,000. A graft measuring approximately 14x5 mm was then harvested from the upper conchal bowl and this was removed. The skin was undermined on either side and then 4-0 chromic was used to close the donor site defect. Once this was done, then the composite graft was sutured in the floor of the vestibule to maximize the airway and prevent the transverse scar band contracture. It was sutured at approximately 10 points. Once this was done, then a conchal ear cartilage graft was harvested from the posterior side of the right ear. This measured approximately 12x3 mm. It was placed into the rim of the nostril and sutured into place.
I am coding this with 15760 and 21235. Please correct me if I'm wrong. They are rolling up the code 21235 to 15760 which I donot agree since these 2 grafts were harvested with different incisions and closure. They only paid us for 15760 and now I am appealing the 21235 to be paid separately.
Thank you for your feedback.