Sinus Surgery - I billed 31296 LT and 31297 RT to UHC. (When performed on the same side these codes are combined into CPT code 31298). When UHC processed the claim they combined these codes into 31298LT. The combined code did not accurately describe the procedure performed. After multiple appeals UHC is upholding their decision per their rebundling policy. The CPT code descriptions for 31296 and 31297 say not to report with eachother when performed on the ipsilateral side. 31296 and 31297 were performed on the contralateral side and should not have been combined into 31298 LT.
Is UHC correct? The difference in reimbursement is around $4000.00.
Is UHC correct? The difference in reimbursement is around $4000.00.