Wiki Rejected code

[jen2744]

I'm trying to file a claim with CPT codes 27513 and 20225. I'm getting an error message that "service line procedure code is missing or incorrect"and cannot figure out why. This was done while inpatient and the dates are correct.

 

[trarut]

Which code is the error message for? Is this from a payer or an edit in your billing system?

 

[jen2744]

I think it's an edit and am guessing it's for 20225 but I was given no other information, just that message. When I post that code, it doesn't even prompt me to add modifiers

 

[trarut]

Per AAPC Coder, both codes are valid & don't have any Excludes1 or 2 notes related to the other code. There is a CCI relationship between the two codes (Code 20225 is a column 2 code for 27513, but you may use a CCI-associated modifier to override the edit under appropriate circumstances. CCI Edit Rule: Standards of medical / surgical practice.) but, since it seems like an internal edit, I would reach out to a lead or manager to try to validate that before attaching a modifier.

 

[jen2744]

Per AAPC Coder, both codes are valid & don't have any Excludes1 or 2 notes related to the other code. There is a CCI relationship between the two codes (Code 20225 is a column 2 code for 27513, but you may use a CCI-associated modifier to override the edit under appropriate circumstances. CCI Edit Rule: Standards of medical / surgical practice.) but, since it seems like an internal edit, I would reach out to a lead or manager to try to validate that before attaching a modifier.

Thank you.