DanielP
New
Dear AAPC, Medical Billing community,
Medicare (Noridian CA) has denied professional insurance claim with entry CPT 33274 for a surgical insertion of a Medtronic leadless pacemaker. I have already utilized every appropriate clinical trial number for the CPT 33274 code listed on the official CMS website page https://www.cms.gov/medicare/coverage/evidence/leadless-pacemakers. When discussing with a Medicare provider representative over the phone, the main (technical) issue is the way the clinical trial number is being entered on an electronic CMS-1500 (HCFA) form. I have corrected each denial by entering the trial number in either Field 23 (prior authorization) and/or Field 19 (additional info section) as instructed. I have followed other requirements from CMS such as entering modifier -Q0 and using ICD-10-CM code Z00.6 as the secondary diagnosis code. All claims with CPT 33274 are corrected and still denied. Please advise.
Medicare (Noridian CA) has denied professional insurance claim with entry CPT 33274 for a surgical insertion of a Medtronic leadless pacemaker. I have already utilized every appropriate clinical trial number for the CPT 33274 code listed on the official CMS website page https://www.cms.gov/medicare/coverage/evidence/leadless-pacemakers. When discussing with a Medicare provider representative over the phone, the main (technical) issue is the way the clinical trial number is being entered on an electronic CMS-1500 (HCFA) form. I have corrected each denial by entering the trial number in either Field 23 (prior authorization) and/or Field 19 (additional info section) as instructed. I have followed other requirements from CMS such as entering modifier -Q0 and using ICD-10-CM code Z00.6 as the secondary diagnosis code. All claims with CPT 33274 are corrected and still denied. Please advise.