midnight1995
Networker
- Messages
- 78
- Location
- Chapachet, RI
Hi am reaching out to see if any one in NJ is having the same issue. The patient are being seen within the 90 day global for post up but in the appointment the provider is addressing new problems unrelated to the post op - The E/M is being billed with the modifier 24 and the diagnosis related to the new problem only.
1.) The insurance denial bundled into the surgery - per Horizon regardless of the modifier or different diagnosis it will deny.
2.) Claim is being sent up for review and still denying.
3.) Reconsideration are being sent in the progress notes supports the modifier 24 as well as the documentation, still denying
Does any one have any suggestions or how they have solved this issue.
Thank you
1.) The insurance denial bundled into the surgery - per Horizon regardless of the modifier or different diagnosis it will deny.
2.) Claim is being sent up for review and still denying.
3.) Reconsideration are being sent in the progress notes supports the modifier 24 as well as the documentation, still denying
Does any one have any suggestions or how they have solved this issue.
Thank you