I'm new to Ortho coding and our insurance reimburser just brought me a denial from Tricare for code 20985. I had coded 27447 w/20985 (they paid 27447). Reason code was:
032: This service is non-coverd. Network providers may not charge beneficiaries for the services. I've been asked if there is anything else I need such as modifiers and I said I didn't think so but since the surgeon does these a lot I was going to check with you guys
My question is does anyone know if this is a procedure that is routinely not paid by most insurance or only certain carriers and is there anything I can submit for an appeal or modifiers that need to be added?
032: This service is non-coverd. Network providers may not charge beneficiaries for the services. I've been asked if there is anything else I need such as modifiers and I said I didn't think so but since the surgeon does these a lot I was going to check with you guys
My question is does anyone know if this is a procedure that is routinely not paid by most insurance or only certain carriers and is there anything I can submit for an appeal or modifiers that need to be added?
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