D.O. performed services.
Claim submitted to Highmark Medicare as follows:
98925
62311-59
Allowed 98925, disallowed 62311-59 as follows:
B15 THIS SERVICE/PROCEDURE REQUIRES THAT A QUALIFYING SERVICE/PROCEDURE BE RECEIVED AND COVERED. THE QUALIFYING OTHER SERVICE/PROCEDURE HAS NOT BEEN RECEIVED/ADJUDICATED. NOTE: REFER TO THE 835 HEALTHCARE POLICY IDENTIFICATION SEGMENT (LOOP 2110 SERVICE PAYMENT INFORMATION REF), IF PRESENT. AND,
M80 NOT COVERED WHEN PERFORMED DURING THE SAME SESSION/DATE AS A PREVIOUSLY PROCESSED SERVICE FOR THE PATIENT.
I searched Highmark Medicare and was unsuccessful at finding clarification for the 835 Healthcare Policy. Are they saying that the ESI is inclusive of the manipulation?
HELP!
Claim submitted to Highmark Medicare as follows:
98925
62311-59
Allowed 98925, disallowed 62311-59 as follows:
B15 THIS SERVICE/PROCEDURE REQUIRES THAT A QUALIFYING SERVICE/PROCEDURE BE RECEIVED AND COVERED. THE QUALIFYING OTHER SERVICE/PROCEDURE HAS NOT BEEN RECEIVED/ADJUDICATED. NOTE: REFER TO THE 835 HEALTHCARE POLICY IDENTIFICATION SEGMENT (LOOP 2110 SERVICE PAYMENT INFORMATION REF), IF PRESENT. AND,
M80 NOT COVERED WHEN PERFORMED DURING THE SAME SESSION/DATE AS A PREVIOUSLY PROCESSED SERVICE FOR THE PATIENT.
I searched Highmark Medicare and was unsuccessful at finding clarification for the 835 Healthcare Policy. Are they saying that the ESI is inclusive of the manipulation?
HELP!