Question Code 25215 and 20924

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Code 25215

1) Has anyone had a problem with Humana Medicare for code 25215-59 (Carpectomy all bones proximal row) bumping against 25447 (Arthroscopy, interposition, intercarpal or carpometacarpal joints) and 26516 ( Capsulodesis, metacarpophalangeal joint; single digit)? Humana Medicare paid for the 25447 & 26516 and not the 25215-59. Any suggestions?


Code 20924

2) A problem we are having with UHC Medicare is when billing 20924 (tendon graft) with 25447 (Arthroscopy, interposition, intercarpal or carpometacarpal joints) it gets denied and we always have to do a reconsideration and send the information from the AAOS (American Academy of Orthopedic Surgeons) and from Decision Health that states as long as the tendon graft was harvested from a different site through a separate incision you can code 20924. Does anyone know if there is anything we can do to prevent this from happening with UHC Medicare on these types of claims?

Thanks
 
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