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Wiki Specialty Code New Patient Denials

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jacwea2782

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We are having an issue with new patient denials in our cardiology department due to the Specialty Code designations. We have some cardiologist that have a primary specialty of cardiology. We also have some that have a primary designation of electrophysiology, but cardiology is listed as a secondary specialty code. I think that we should be appealing these new patient denials if they saw a regular cardiologist and then the patient is seeing one of our EP guys since they were seeing them as a different subspecialty. Has anyone had experience with denials based on these secondary specialty codes? Any success on appeal? Thank you!
 
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