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Wiki 20936 and 20930 Appeal Letter

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MsAnna

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Longview, WA
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Has anyone had to write an appeal letter for non payment of these two graft codes. I know that they are rarely paid (if ever) but in the office in which I am employed, they want me to write an appeal letter and then if we can't get payment after that process, then they will create an auto adjustment. My request is for any guidance on how to do an appeal for something that has no RVU's and usually has a carrier admin policy that they just do not pay for these codes. Where to start and how to create medical necessity.

Any suggestions would be fantastic and very much appreciated.
 
I'm not aware of any carriers that will pay these codes anymore. I'm no longer billing them out. In the long run, I don't think it's worth the time and trouble to appeal something that's not going to get paid.
 
On a recent webinar Medtronic encouraged to continue to use these codes so that a value may be placed to them in the future.
 
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