erinmiller
Contributor
We've been trying to get a denial from Medicare for a couple patients that had Lipiflow so we can forward it to their secondary insurance. The code is 0207T (which is not covered by medicare) and I've been billing it with ICD9 373.12 before oct 1 & ICD10 H00.021, H00.022, H00.024, H00.025 (HORDEOLUM INTERNUM) after oct 1. or should I be using H01.001, H01.002, H01.004, H01.005 (BLEPHARITIS, UNSPEC)?
Medicare's denial CO-4 "The procedure code is inconsistent with the modifier used or a required modifier is missing."
0207T - 50 GY - 1 unit - 373.12 (before oct. 1) - denied
0207T - 50 GY - 2 units - 373.12 " " - denied
0207T - E1 GY - 1 unit - 373.12 " "
E2 GY - " " - 373.12
E3 GY - " " - 373.12
E4 GY - " " - 373.12 - denied
0207T - E1 GY - 1 unit - H00.024 (after Oct 1- different pt)
E2 GY - " " - H00.025
E3 GY - " " - H00.021
E4 GY - " " - H00.022 - denied
Any clue as to what I'm doing wrong with billing these. We're about to try billing w/out GY. And since this px is lid specific, I feel it necessary to use the E codes, but I could be wrong, but we did have the first 2 claims denied w/out the E codes??? Really wish Medicare would just deny these so we can move on.
Medicare's denial CO-4 "The procedure code is inconsistent with the modifier used or a required modifier is missing."
0207T - 50 GY - 1 unit - 373.12 (before oct. 1) - denied
0207T - 50 GY - 2 units - 373.12 " " - denied
0207T - E1 GY - 1 unit - 373.12 " "
E2 GY - " " - 373.12
E3 GY - " " - 373.12
E4 GY - " " - 373.12 - denied
0207T - E1 GY - 1 unit - H00.024 (after Oct 1- different pt)
E2 GY - " " - H00.025
E3 GY - " " - H00.021
E4 GY - " " - H00.022 - denied
Any clue as to what I'm doing wrong with billing these. We're about to try billing w/out GY. And since this px is lid specific, I feel it necessary to use the E codes, but I could be wrong, but we did have the first 2 claims denied w/out the E codes??? Really wish Medicare would just deny these so we can move on.