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I have a doctor continues to tell me then I am under coding his procedures. Could someone please explain to me in Laymans terms the difference between 92928 and 92930?
A
alwilkinson@herzing.edu
92928 is a standard stent using a balloon to open the vessel. 92930 is for complex cases with hard, calcified plaque that a balloon can't move. In those cases, he must use a "drill" (atherectomy) to shave plaque before the stent fits. If he uses a Rotablator or Diamondback, 92930 is the right code. Using 92928 when he does an atherectomy means you’re missing the extra skill and time he put in
I am billing an G0439, G0444-59, 99497-33, 99213-25, G2211 and 99406. My question is, do I need to add a modifier to 99406 and if so which one. I have been reading in the Forum and can't seem to find an answer based on what I am billing. Any help would be appreciated. Thank you.
Has anyone billed 95165 to United Healthcare and getting their claims denied? Our claims are being denied when we provide supporting documents. Does the notes have to reflect the breakdown of the vials? e.g. if you bill 20 units, does the notes have to reflect the breakdown of the vials 10 cc 1 unit, and 10 cc 1unit? Or do we bill 10 units on 2 lines. Eg. 95165 1 unit, 95165 mod 59 1 unit?
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