?'s regarding cpt codes 11200,11201,17000

rthames052006

True Blue
Local Chapter Officer
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Hello,

I am new to coding these types of procedures... first I should start by saying I just started a new job for a family practice and I am working the denials I came across this one this is how it's billed.

11200-GA,11201 ga-58, 11201 ga, 17000 -59.

The insurance only paid on the 17000 the other codes they said are reduced benefits and pt responsible for like $17.94 on each of the charges.

My "guess/gut feeling is that this is not coded correctly, I started working on this 5 minutes before quitting time. I plan on going in Tuesday to do some research since I am not well versed in procedures... My background is strictly e/m.

If anyone has any suggestions/thoughts please let me know.

I think they used the wrong modifier I know that 11201 is an add on code and really doesn't require the modifier but i haven't checked the cci edits yet either....

Any thoughts
 

Lorisvg

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I would code your scenario:
11200 GA
11201 x2 GA
17000 modifier 51 (any GA for this one?)
 

csruiz

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What DX are you using for this proceedure? I can't seem to get any claims paid for this proceedure. Denied for not being medically necessary. Does the GA mod make a difference?
Thanks, Cindy
 
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