aunderhill
Networker
We are having an issue getting 34713’s paid. The claims are all EVAR’s with co-surgeons.
Here are some denial reasons we have received:
CO151: Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. (MEDICARE)
COB20: Procedure/service was partially or fully furnished by another provider. (MEDICARE) (This was originally without 62 modifier.)
It was my understanding that both surgeons bill every code with 62 modifiers. Is this correct?
Are these denials because the co-surgeon billed first WITHOUT a 62 modifier?
If only one surgeon can report 1 code , who get's the code when the documentation is the same?
Why does the Cpt book say you can report twice but the MUE shows 1?
Is there something you see from the examples below or do you have some insight into this code?
Thank you in advance!!!!
Case 1- 34705,62 – 34709,62 – 34713,62,RT
Doctor 1
Doctor 2
Case 2- 34705,62 -34709,62 – 34713,62,LT – 34713, 62,RT
Dr 1
Dr 2
Here are some denial reasons we have received:
CO151: Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. (MEDICARE)
COB20: Procedure/service was partially or fully furnished by another provider. (MEDICARE) (This was originally without 62 modifier.)
It was my understanding that both surgeons bill every code with 62 modifiers. Is this correct?
Are these denials because the co-surgeon billed first WITHOUT a 62 modifier?
If only one surgeon can report 1 code , who get's the code when the documentation is the same?
Why does the Cpt book say you can report twice but the MUE shows 1?
| 34713 | 1 | 3 Date of Service Edit: Clinical | CMS Policy |
Is there something you see from the examples below or do you have some insight into this code?
Thank you in advance!!!!
Case 1- 34705,62 – 34709,62 – 34713,62,RT
Doctor 1
Doctor 2
Case 2- 34705,62 -34709,62 – 34713,62,LT – 34713, 62,RT
Dr 1
Dr 2