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Wiki Denial for 33999 - LV Lead Extraction

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Heartcoder09

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I received a denial that stated that we must include a definition or description of the nature, extent and need for the procedure or service, as well as the provider's time, effort and equipment necessary to provide the service. The record does not include a separate letter identifying the procedure and comparable code. Therefore no payment is allowed. In the past, we've submitted records and have gotten paid. This is new to me. Has anyone received a denial from an insurance company stating they need this information?
 
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When ever i bill an unlisted code (I wouldn't recommend billing unlisted for LV lead extraction without the report to review) i add a line comment on the procedure done (lv lead removal in your case) then give comparable (33999 comparable to 33244). Getting unlisted paid is always a challenge.

That being said, I would bill a LV lead removal with PPM or ICD lead removal codes based on the system type. LV lead removal for ICD system, 33244 and for PPM i would look at 33235.

Sincerely,
Margaret
 
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