Hello everyone -
Having some conflict regarding the level of service 99204 w/ CPT 25600 - no manipulation and puts a short arm cast because patient does have a radius fracture. UHC denied the level of service
We coded a 99204, new patient to ortho
problem = moderate - acute complicated injury
data = minimal - xray order
risk = moderate - short arm cast
I am assuming they consider the short arm cast under " low " and not moderate. I can see this is why? open to suggestions
Having some conflict regarding the level of service 99204 w/ CPT 25600 - no manipulation and puts a short arm cast because patient does have a radius fracture. UHC denied the level of service
We coded a 99204, new patient to ortho
problem = moderate - acute complicated injury
data = minimal - xray order
risk = moderate - short arm cast
I am assuming they consider the short arm cast under " low " and not moderate. I can see this is why? open to suggestions