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Wiki canaloplasty denial humana

Thread starter dppatel79
Start date Jun 6, 2013

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dppatel79

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Jun 6, 2013

Im not sure how to go about this denial. I billed a canaloplasty 66175 transluminal dilation of aqueous outflow canal; with retention of device or stent, for open angel glaucoma. I have appealed the first denial for not medically necessary and got paid. Now 4 months later i have received another take back on the same claim stating its experimental/ investigational. Its a medicare advantage pt, and medicare pays the code. Anyone have any idea how to fight this?

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