torihamill
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My provider billed a claim 10/24/11 CPT 45380 DX 56210, V7651, 78799, 5645.
This same patient had another colonoscopy on 11/19/14 and it was coded CPT 45378 DX V1272. Patient has Aetna for both service dates and there is a small balance due from the 2014 procedure. Patient wants doc to code as routine visit and stated that insurance will pay in full since it's a follow up to the biopsy from 2011.
When I sent a request to the office about the change for the 2014 service, the person in the office said no because in 2011 patient had screening.
I have not seen the notes and either the person in the office or the doctor does the coding.
Please advise if it would be possible to make any change to the 2014 claim so it would be covered as routine/screening/preventative.
Thank you,
Tori
This same patient had another colonoscopy on 11/19/14 and it was coded CPT 45378 DX V1272. Patient has Aetna for both service dates and there is a small balance due from the 2014 procedure. Patient wants doc to code as routine visit and stated that insurance will pay in full since it's a follow up to the biopsy from 2011.
When I sent a request to the office about the change for the 2014 service, the person in the office said no because in 2011 patient had screening.
I have not seen the notes and either the person in the office or the doctor does the coding.
Please advise if it would be possible to make any change to the 2014 claim so it would be covered as routine/screening/preventative.
Thank you,
Tori