Wiki McKesson Edits

[bettybutler]

Does anyone else have problems with denials coming from the McKesson edits? Has anyone had any luck in appealing these denials?

 

[Nat]

Our group has had to enter the codes into mckesson and see how they want it coded. The collectors then change the claim to that way and bill a corrected claim. You won't believe some of the responses you will get. They aren't according to CPT rules or any other rules you have seen before.

Mema,CPC

 

[bettybutler]

So how do you get access to the McKesson edits to enter in your codes?

 

[Lisa Bledsoe]

Carriers such as Cigna and BCBS who use McKesson edits have claim check sections where you can enter the codes to see what will be paid/denied and also determine if denied codes will pass their edits with modifier -59.