Wiki Help needed for OAE and others

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Bamboo

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Farmington, Connecticut
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1. Amerigroup denied OAE(92587) as "experimental". pt are younger than 5 yr, icd v20.2+v72.11, and 389.9 in some pt. How do we appeal?

2. Wellcare rejects claims for vaccinations with both hepA & hepB (90633+90744), since they share the same icd code V05.3. The claims were rejected by the system as "duplicate Dx codes".

Any advice and suggestion will be greatly appreciated.

Bamboo
 
The denial you are getting from AGP is due to the diagnosis code that is being billed with the 92587. You need to contact AGP and ask for a CPB in regards to evoked potential studies.
 
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