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Wiki I&D and Biopsy done at different sites

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cheryl.vanklingeren

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Doctor did a shave biopsy on the forehead and an I&D on the right axillary vault on the same day. UHC is denying 11100 as inclusive even after submitting medical records showing 2 different sites. These codes do not bundle so I don't think a modifier would be appropriate. I'm not sure where to go from here, any advice/input would be appreciated!
 
cherylvk_3061112 said:
Doctor did a shave biopsy on the forehead and an I&D on the right axillary vault on the same day. UHC is denying 11100 as inclusive even after submitting medical records showing 2 different sites. These codes do not bundle so I don't think a modifier would be appropriate. I'm not sure where to go from here, any advice/input would be appreciated!
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I would just try to put the modifier 59 on the 11100 to override it. Some insurance companies have their NCCI edits screwed up on their systems.
 
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