ollielooya
True Blue
Here we go again....
Following up on AR sent to me by one of the major carriers with whom we have a contract.
99213-25 (272.0) denied as incidental to primary procedure
99396 (V70.0) paid
Q0091 (V76.47) denied as incidental to primary procedure
G0101 (V72.31) denied as incidental to primary procedure
93000 (V70.0)
Is the 99213-25 a legitimate denial? Provider relations wasn't that helpful other than to say we can't bill two EM codes and to go check out their editing policies at their web site. Really? It appears the preventive and problem related EM's have been paid in the past. Guess we're going to have to start asking the patients to reschedule their well visit exams if these denials will be a trend. Is an appeal in order? Missing modifiers? Advice, anyone?
Following up on AR sent to me by one of the major carriers with whom we have a contract.
99213-25 (272.0) denied as incidental to primary procedure
99396 (V70.0) paid
Q0091 (V76.47) denied as incidental to primary procedure
G0101 (V72.31) denied as incidental to primary procedure
93000 (V70.0)
Is the 99213-25 a legitimate denial? Provider relations wasn't that helpful other than to say we can't bill two EM codes and to go check out their editing policies at their web site. Really? It appears the preventive and problem related EM's have been paid in the past. Guess we're going to have to start asking the patients to reschedule their well visit exams if these denials will be a trend. Is an appeal in order? Missing modifiers? Advice, anyone?