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Newbie to ENT Billing

C

cainba

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Location
Covington, GA
PLEASE! M'caid denies cpt code 92557 stating it has a age restriction up to 20 years and 11 months. I cannot find any supporting documents to support this denial. Does anyone else know of this and where can I view it. It's not in the Current Procedural codebook. Would there be another code to support the type of visit as a adult?
Help Please!!!:mad:
 
Sounds like a Local Coverage Determination. Check your Carriers website to see what justifies Medical Necessity and coverage limitations.
 
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