denial

  1. A

    Wiki do you need a modifer when using 97032

    I have just received a denial on a claim that I submitted to Tufts. I am working for a chiropractor and I have used 97032 before with no modifier used and now I get the denial CO-182 meaning Payment adjusted because the procedure modifier was invalid on the date of service. This has never...
  2. M

    Wiki ICD-10 DX for smoking cessation

    I am having some trouble with Medicare paying 99406 or 99407 when billed with E/M code using Dx F17.210. The denial is for "not medically necessary" Any suggestions? I appreciate any help Maru
    • mquiroz
    • Thread
    • code denial f17.210 medically suggestions
    • Replies: 7
    • Forum: ICD-10
  3. J

    Wiki Home Health

    Can anyone help me with this? If a patient is being treated with Home Healthcare and the referring physician authorizes and or signs the Plan of Care but it is not filed to insurance and is not timely filing, can we A) still bill for denial or B) can we file for the re-certification even thought...
  4. L

    Wiki 66761-LT denial

    I've received a denial from an insurer for 66761-LT stating it was within the global period of another procedure. Exactly 7 days prior we billed for 66761-RT. Am I correct in thinking the 66761-LT wouldn't be included with 66761-RT since it is a separate procedure done on a different site of...
  5. E

    Wiki Blue Cross Denial for POS 32 w/ 99310

    Hello, I have a few claims sitting on my desk denying because they are stating that 99310 is incompatible with POS 32. Our physicians visit patients in the Nursing Home. Now - BC has paid 99304-99309's, as this this pts had been in the POS for some time. (Nursing Home bills using POS 32...
  6. E

    Wiki 99310 in POS 32... Blue Cross

    Hello, I have a few claims sitting on my desk denying because they are stating that 99310 is incompatible with POS 32. Our physicians visit patients in the Nursing Home. Now - BC has paid 99304-99309's, as this this pts had been in the POS for some time. (Nursing Home bills using POS 32...
    • enascimento
    • Thread
    • 99310 blue cross denial nursing home pos 32
    • Replies: 1
    • Forum: E/M
  7. B

    Wiki N.C. Mediciad Denial for preventive visits on children

    We just recently went to ECW and we cannot get reimbursed for preventive care visits on children. We are using the EP modifier with the CPt codes. our denial reason states attending provider not eligible on service dates. and B7=This provider was not certified/eligible to be paid for this...
  8. M

    Wiki Medicare denial for 88305 and 88342

    I got denial for 88305 and 88342 from Medicare. According to remittance advice modifier(S) was missing. Do I need to apply modifier 59 to 88305? I am confused I did not know that any modifier needed for those codes.
  9. D

    Wiki 73564 denial

    hi I am new to orthopedic and I keep getting a denial for 73564 RT with diagnosis S80.01XA indicating diagnosis inconsistent with procedure, any advice would help, thank you Laura
  10. S

    Wiki HUMANA denial for J02.9 not allowed as primary

    We just received a denial from Humana insurance stating that J02.9 is an invalid primary dx code. I do not see any specific guidelines for that code saying it cant be primary. Can someone please let me know if they are having trouble with this also. Thank you
    • ssharp
    • Thread
    • code denial humana j02.9 primary
    • Replies: 1
    • Forum: Pediatrics
  11. D

    Wiki TSH denials from medicare

    Hello! I work for a neurologist who regularly orders thyroid stim hormone assays (CPT 84443) in conjunction with other tests to check for Peripheral neuropathy after a trans ischemic attack or a stroke. The tests that come back abnormal are being paid, but we have 3 that came back normal that...
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