Wiki Excision Tumor 21933

[ssharp]

I am looking for coding advise. The physician preformed a excision of a cancerous deep tissue tumor and coded to the best of his ability. We have recieved an insurance denial because it is saying a referral is needed. Can someone please review this note to make sure there are no other codes that could have been used.

left back side, transverse incision made through sub q unitll mass encountered, followed capsule circumferentially, on deep aspect of mass was underedge of trapezius and latissimus, excisied with metz, wound closed with 3-0 vircyl and 4-0 plain gut 6 cm diameter 21933

 

[mitchellde]

Did they state a referral or are they wanting field 17 populated. There are 3 qualifiers to use in this field to indicate referring provider, ordering provider, or supervising provider.

 

[ssharp]

Practice please review per call to payer per Karen provider is unauthorized to bill service, per rep claim dept would have authorization on file if provider was authorized to bill this service provider has 120 days from date of denial to appeal claim please advise what action you would like to take.