Hi,
I'm in need of HELP, I have a 2015 claim still outstanding due to coding issues. Please see report
ERCP:
The previously placed stent was in good position.It was removed atraumatically with endoscopic snare.The papilla had a normal post-sphincterotomy appearance. Papilla was cannulaed with 9-12 mm balloon catheter. Cholangiogram was obtained after deep cannulation. Common bile duct was 8 mm in size without filling defects in it. A sweep was preformed using balloon catheter.Sludgy material was delivered .Good drainageof bile and contrast noted after the procedure .Pancreatic duct was not cannulated or specified during the procedure .
An EGD w/ biopsy was also performed . Claim was billed as followed .
99222-25
43275
43239 XS claim was denied due to incorrect modifier .
Report was then reviewed by a new coder and reposted charges as followed:
99222-25
43276
43264 51
43239 XS
74328 26
Keep in mind this claim is a Medical HMO plan .Claim was again rejected due to modifier.
If you can help as to is correct on the proper coding.
Thank you so much in advance .
I'm in need of HELP, I have a 2015 claim still outstanding due to coding issues. Please see report
ERCP:
The previously placed stent was in good position.It was removed atraumatically with endoscopic snare.The papilla had a normal post-sphincterotomy appearance. Papilla was cannulaed with 9-12 mm balloon catheter. Cholangiogram was obtained after deep cannulation. Common bile duct was 8 mm in size without filling defects in it. A sweep was preformed using balloon catheter.Sludgy material was delivered .Good drainageof bile and contrast noted after the procedure .Pancreatic duct was not cannulated or specified during the procedure .
An EGD w/ biopsy was also performed . Claim was billed as followed .
99222-25
43275
43239 XS claim was denied due to incorrect modifier .
Report was then reviewed by a new coder and reposted charges as followed:
99222-25
43276
43264 51
43239 XS
74328 26
Keep in mind this claim is a Medical HMO plan .Claim was again rejected due to modifier.
If you can help as to is correct on the proper coding.
Thank you so much in advance .