Wiki 493.90 w/ 94060 - denial help

[june616]

Claim was billed Humana like this:

dx 493.90 (asthma nos)

99213-25
94060


Humana denied 94060 as "not expected with dx billed". Any insight on why this would be? 94060 is the correct code because spirometry was performed before and after bronchodilator. Should I appeal and send documentation? Is there something wrong with the dx that was used? Please help...Thank you!

 

[t.rosales]

Same here.

 

[mitchellde]

You have used unspecified asthma with unspecified episode.. The provider needs to be more specific with the asthma diagnosis. Check the documentation to see if there is more. But more and more the payers are not paying for procedures with unspecified asthma.