• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 30th Nov, 2021. The site will be offline from 8:30PM (MT) till 10:30 PM MT. We apologize for any inconvenience this may cause.

?'s regarding cpt codes 11200,11201,17000

rthames052006

True Blue
Local Chapter Officer
Messages
1,904
Location
York, Pa
Best answers
0
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

Networker
Messages
93
Best answers
0
I would code your scenario:
11200 GA
11201 x2 GA
17000 modifier 51 (any GA for this one?)
 

csruiz

Guest
Messages
20
Best answers
0
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
 
Top