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Wiki 33225 denied

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coders_rock!

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Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me
 
coders_rock! said:
Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me
Click to expand...

Well, for one, you've got a discontinued procedure modifier on it - usually they want records for those. I can't see any other reason to deny it, though. ;)
 
coders_rock! said:
Hi everyone,

My Dr. billed:

33249
33225-53
33233-51
33223-51
71090-26
36005

Payer is denying 33225, can anyone tell me why? It is unclear to me
Click to expand...

I agree with Brandi, the 53 modifier could be the issue. I also consider 36005 inherent to the procedure and not separately billable. Did the payor reimburse for 36005?

HTH :)
 
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