Wiki number of units for 59400

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astough

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How many units are billed for 59400? I have always billed "1" but now have an insurance company that is very insistent that this is incorrect. Am I missing something?? All others insurance companies are paying when billed with "1" unit. Help!!!
 
Consultant

I am also seeing a commercial carrier break the 59400 code into two parts on their ERA, the allowed amount being the same for now. I do not see any description changes in the 2015 CPT code book. Any ideas as to what is to come?
 
I have never heard of a claim being denied for only having one unit with a 59400 code.

Is it a twin case? Not that you would bill two units then but maybe that is what the insurance is thinking?

I would ask for the policy on how to bill the 59400 code in writing, they should be able to fax or email you the correct way to bill it to their insurance.

Did you just talk to one person at the insurance company? As we all know, sometimes if you call back later and get someone else you can get a completely different answer.

Hopefully you get an answer soon, let us know what they say.

Amanda Kane, CPC, COBGC
 
Scrubbing Claim

It's the way they are scrubbing the claim. They are separating it into two portions with the same CPT code and paying two different amounts.
 
Number of units for 59400

I haven't seen this either. In my state, even when billing twin deliveries we don't change the units. We bill a different CPT code for the second twin if it's a vaginal delivery.

Tami Walker, CPC
 
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