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authorization

  1. C

    Wiki Billing Questions Highmark Speech Therapy Claims Denials

    So this is more billing related rather than coding related... But I am at a loss and figured it would not hurt to ask. I work for large FQHC as a Coding and Billing specialist. We bill for Speech and Occupational Therapy.. These kid's are seen multiple times a week and usually exhaust their...
  2. J

    Wiki Prior Authorization

    I am wondering if you are getting authorization for a procedure but you are unsure of the exact code you need do you get the higher paying code authorized and are lower paying codes covered under this authorization. For example: My physician states he is ordering a echocardiogram so we get...
  3. L

    Wiki Authorization Denials, Surgery

    Curious- Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that they've appealed successfully? Example: Surgery paperwork may states "Knee arthroscopy, diagnostic, meniscectomy" CPTs: 29870, 29881 called on/submitted for surgery...
  4. L

    Wiki Surgery Auths

    Curious- Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that they've appealed successfully? Example: Surgery paperwork may states "Knee arthroscopy, diagnostic, meniscectomy" CPTs: 29870, 29881 called on/submitted for surgery...
  5. K

    Wiki 62311 vs 64483

    I have a physician that request 62311 but does 64483 and i have received numerous denials for no authorization and now I have received several request for take backs for no authorization. I am unclear of the difference of these two codes and what to do???
  6. D

    Wiki Auth Appeal Letter

    Help! I am in need of a template or sample of an a letter appealling a denial for no authorization obtained.I have a denial from a carrier and am stumbling over exactly how to word this, so a sample, (all info redacted) would be soooo appreciated. Thanks!!:)
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