kroy2015
New
Hi everyone!
We keep getting denials from Wellmark BCBS for 92567 stating that they only pay for 2 tymps in a 12 month period unless a diagnosis code justifies more than two in a year. We submitted one with H93.293 (Other abnormal auditory perceptions) and received this denial for the third tymp we have done on this patient. Does anyone have any suggestions for what diagnosis code to use? The documentation justifies chronic serous otitis media as well as a positive family history of hearing loss. Are there any other codes we can use to get this paid based on the patient's history?
Thanks!
We keep getting denials from Wellmark BCBS for 92567 stating that they only pay for 2 tymps in a 12 month period unless a diagnosis code justifies more than two in a year. We submitted one with H93.293 (Other abnormal auditory perceptions) and received this denial for the third tymp we have done on this patient. Does anyone have any suggestions for what diagnosis code to use? The documentation justifies chronic serous otitis media as well as a positive family history of hearing loss. Are there any other codes we can use to get this paid based on the patient's history?
Thanks!