Wiki 37215 Billing issues with Novitas

[RAND]

Good afternoon, I am seeking some enlightenment on billing the 37215 code to Novitas - Texas.
We have recently begun receiving denials on this code with a denial reason of missing a modifier. I have searched the website, publications, policies, etc.. and apparently I am missing something here. I have spoke with Novitas but they of are no help the policy they referred me to stated nothing about a modifier requirements for this code.
This is a new development as we have billed this procedure for sometime without issue. Any direction in this area would be greatly appreciated, and thank you in advance for your assistance.

 

[abegnaud]

37215 denial

I am having same issue with Novitas. Has anyone found a solution?

 

[jcrews@wacocardiology.com]

We are also. There is another post under Cardiology for this same problem. No answers just people with this problem. If anyone has the answer, please share with us. Meanwhile we are trying to get Novitas to consider that they have probably put in an incorrect edit as they tell us we have to have a modifier that we can't add because there was no study. It may be they just want to deny to look at records, but they don't seem to know.

 

[angelyauman]

I also have received the same denial. It is referring to the "clinical Trial" modifiers. But this is not a clinical trial procedure code. I had to send in a redetermination. I am still waiting for their response. I will update once I receive it.

 

[jcrews@wacocardiology.com]

37215 Carotid Stent Novitas

We have been told finally that they realize they made a mistake and will reprocess the claims because "multiple people have called attention to this". As always we have to do that because they flat out ignore one or two people telling them there's an error. It would be great if someone else would call and see if they get the same response now.