Wiki Billing for the facility for CPT 15823

[smp.md@live.com]

I work for a health insurance company and reviewed a claim denial today with the provider for the facility and this is a medicare replacement plan *** they billed 15823 LT and 15823 RT ** the surgon also billed 15823 LT and 15823 RT and was paid and the facility claim was denied as units maxed *** the auth on file is for the facility *** this was billed on a UB04 *** can you explain why the facility claim was denied. I looked in the Medicare Guidelines and the CCI and could not find an answer. This was an outpatient surgery center.

Thank you