sdunaway1
Guru
Our doctor performed a removal of Cervical plate and exploration of the prior fusion at C5-6, and a new ACDF at C4-5 and C6-7 with an anterior cervical plate extending from C4 down to C7 due to C4-5 and C6-7 stenosis spinal cord compression. We billed the surgery out to Regence Blue Shield of Id as : 22551,22552,22830-51,59 , 22845,20931. All codes were allowed except for the 22830 so we sent in appeal stating that the 22830 was performed on level C5-6 due to a upper motor neuron injury , and the new fusion codes were performed at levels C4-5 and C6-7 .
Regence sent us another denial and have asked us to appeal to an outside company along with paying a $50.00 filing fee. Has anyone else had issues with this type of coding and I am now wondering if a removal code would have been better than an exploration code.
Any help is appreciated, thank you so much,
Stephanie
Regence sent us another denial and have asked us to appeal to an outside company along with paying a $50.00 filing fee. Has anyone else had issues with this type of coding and I am now wondering if a removal code would have been better than an exploration code.
Any help is appreciated, thank you so much,
Stephanie