kcowan
Guest
I HAVE BEEN HAVING TROUBLE WITH UHC (OPTUM) THEY HAVE BEEN DENYING THE PROCEDURE 31231 STATING THAT OUR DOCUMENTATION IS INCOMPLETE NO MATTER WHAT WE DO I CAN'T GET THEM PAID? THIS IS THE ONLY INSURANCE WE ARE HAVING TROUBLE WITH. THE OFFICE MANAGER AND THE DOCTORS STATE IT IS COMPLETE?
THIS IS A SAMPLE OF THE PROCEDURE NOTE:
FINDINGS: DIAGNOSTIC ENDOSCOPY REVEALED INFLAMED MUCOSA WITHOUT SUSPICIOUS LESION
NASAL SEPTUM-DEVIATED TO THE LEFT POSTERIORLY +2
RT INFERIOR TURNBINATE: NORMAL
RT MIDDLE TURBINATE: NORMAL
RT MIDDLE MEATUS: NORMAL
RT SPEHENOTHMOID RECESS: NORMAL
RT POSTERIOR CHOANAE: NORMAL
LT INFERIOR TURBINATE: NORMAL
LT MIDDLE TURBINATE: NORMAL
LT MIDDLE MEATUS: NORMAL
LT SPHENOETHMOID RECESS: NORMAL
ADENOID MASS: NOT OBSTRUCTIVE
PROCEDURE: AFTER VASOCONSTRICTION AND TOPICAL ANESTSHESIA WAS ESTABLISH THE ENDOSCOPE WAS INTRODUCED INTO THE RIGHT NASAL AIRWAY AND STSRUCTURES FROM TEH NARES TO THE POSTERIOR CHOANAE WERE EVALUATED. THE SCOPE WAS THEN REMOVED AND THE SAME PROCEDURE REPEATED ON TEH OPPOSITE SIDE. THE FINDINGS ARE NOTED ABOVE.
TOLERANCE: GOOD
I ASK THE REP WHAT IS MISSING THEY TELL ME INTERIOR NASAL CAVITY EXAMINATION, MIDDLE MEATUS, SUPERIOR MEATUS, TURBINATES, BUT FROM WHAT I CAN SEE ALL THE ELEMENTS ARE THERE? WHAT AM I MISSING?
THIS IS A SAMPLE OF THE PROCEDURE NOTE:
FINDINGS: DIAGNOSTIC ENDOSCOPY REVEALED INFLAMED MUCOSA WITHOUT SUSPICIOUS LESION
NASAL SEPTUM-DEVIATED TO THE LEFT POSTERIORLY +2
RT INFERIOR TURNBINATE: NORMAL
RT MIDDLE TURBINATE: NORMAL
RT MIDDLE MEATUS: NORMAL
RT SPEHENOTHMOID RECESS: NORMAL
RT POSTERIOR CHOANAE: NORMAL
LT INFERIOR TURBINATE: NORMAL
LT MIDDLE TURBINATE: NORMAL
LT MIDDLE MEATUS: NORMAL
LT SPHENOETHMOID RECESS: NORMAL
ADENOID MASS: NOT OBSTRUCTIVE
PROCEDURE: AFTER VASOCONSTRICTION AND TOPICAL ANESTSHESIA WAS ESTABLISH THE ENDOSCOPE WAS INTRODUCED INTO THE RIGHT NASAL AIRWAY AND STSRUCTURES FROM TEH NARES TO THE POSTERIOR CHOANAE WERE EVALUATED. THE SCOPE WAS THEN REMOVED AND THE SAME PROCEDURE REPEATED ON TEH OPPOSITE SIDE. THE FINDINGS ARE NOTED ABOVE.
TOLERANCE: GOOD
I ASK THE REP WHAT IS MISSING THEY TELL ME INTERIOR NASAL CAVITY EXAMINATION, MIDDLE MEATUS, SUPERIOR MEATUS, TURBINATES, BUT FROM WHAT I CAN SEE ALL THE ELEMENTS ARE THERE? WHAT AM I MISSING?