Wiki Help please!!

[seandwillis]

Please I need some help. Company I work for is asking me about this scenario. i have no clue. Provider is billing cpt code 95921 and 95922 with diagnosis code 337.00. Their claim keeps getting denied because it comes up as an experimental procedure. What dx code should accompany those cpt codes. Why is it getting denied as a legit claim?

 

[Herbie Lorona]

I would suggest calling the insurance company that denied this claim to find out why they might consider it experimental. Some insurance's cover certain procedures and others will consider it experimental. You may have to appeal the claim but I would definitely call them first to see what's up with it.