Audiology coding question

cs714

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Provider is billing bilateral dx codes with repairs codes for rt side. Insurance stating that the modifier and procedure code are incompatible V5014,RT with a H903
 

nomerz

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Westminster, CO
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Can you query the provider? If the documentation supports right side only, I would code H90.A21 or H90.41, depending on whether they have restricted or unrestricted hearing on the left ear...
 

cs714

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The claim is from 2016 and patient would have restricted hearing on left side.
 

COrtmann

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Medina, OH
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Right side Sensorineural Hearing Loss with restricted hearing on the left side

The claim is from 2016 and patient would have restricted hearing on left side.

It depends on when the patient received the services in 2016. If it was prior to 10/1/16, then code H90.5 would have to be used due to the restricted hearing loss on the other side. If the patient was seen after 10/1/16 then code H90.A21.
 
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