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Wiki Denial N674

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cris722

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Harlan, KY
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Any help would be appreciated. I cannot find out any information.


Denial code N674: Not covered unless a pre-requisite procedure/service has been provided.


Billed 60 yr old lady for a joint injection to the right knee. Insurance is Anthem BC/BS.

20610 RT with diagnosis code M25.561, place of service is 11.

No other procedure code was billed on this date of service joint injection only.
 
Was a HCPCS code reported for the drug that was injected? Some payers will deny if only the injection code is reported.
 
cris722 said:
No I did not think to use a HCPCS code.
Click to expand...
If your physician practice supplied the medication that was injected, there should be a HCPCS code for that medication. Payers also sometimes require that the HCPCS be reported with no charge when supplied by the patient (e.g., purchased at the pharmacy and brought in for injection).
 
Cynthia Hughes said:
If your physician practice supplied the medication that was injected, there should be a HCPCS code for that medication. Payers also sometimes require that the HCPCS be reported with no charge when supplied by the patient (e.g., purchased at the pharmacy and brought in for injection).
Click to expand...


Thank you. We did supply the medication Decadron. So I should have also billed J1100 with the 20610?
 
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