Wiki Vocal Cord Immobility

[mentsa]

Our providers are using Restylane in an injection on our patient's vocal cords for immobility. We are billing the cpt code J3490 along with cpt 11950, 99070 and 11950. We are having trouble getting the insurance companies to pay for the J3490 (Restylane)? Does anyone else bill for this procedure and if so are you having this issue? Any input on this will be greatly appreciated.

 

[trarut]

What denial code(s) are you receiving from the payers? And are you reporting the drug name, dose, NDC in the narrative field for the J3490?

 

[mentsa]

Actually they are not acknowledging the code at all. They are not even listing on the claim on the eob or when I look at the claim online. We do have an the ndc number on the claim and it is on the claim when I look at it in the clearinghouse. So at this point I'm a little confused. I've been told that insurance will not pay for Restylane at all and am starting to wonder if that is the case.

 

[trarut]

I'd call the insurance and ask them to review the received file to find out where the code went when it hit their system.

 

[mentsa]

I'd call the insurance and ask them to review the received file to find out where the code went when it hit their system.

Thank you. I'll call them. I appreciate your help. Have a great day.

 

[trarut]

Good luck! I hope you're able to get some information.

 

[freespririt0806]

Thank you. I'll call them. I appreciate your help. Have a great day.

hi, my first question is was this done endoscopically? , i would look at 31513...31574
the code you are using is for subcutaneous, this injection is not done subQ

 

[mentsa]

hi, my first question is was this done endoscopically? , i would look at 31513...31574
the code you are using is for subcutaneous, this injection is not done subQ

Thank you so much. I talked to our doc and he said that he did do the 31574.