Wiki Urgent help needed for iud coding

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Girlzsmom66

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I have a patient who is getting an IUD and is 65 years old. She is NOT on Medicare and refuses to take it.

She had a hysteroscopy 58558 for polyp N84.0. At the time of her hscope, she had an IUD removed and a new IUD re inserted. 58301 and 58300 for hormone replacement and aub.

Our clearing house won't let the claim bypass them due to age? Does this sound appropriate or familiar to anyone?

I was asked to handle this coding problem although my supervisor is the one who coded and billed the procedures. She also added some strange modifiers to them.

ANY suggestions/help would be greatly appreciated!

Thanks fellow coders!!!
 
This is an abnormal situation. Is it rejecting at the clearinghouse or is it denying via the patient's insurance carrier? I've worked with several clearinghouses and none have applied claim edits like that, which is why I'm asking for clarification.

If it is the clearinghouse, you may need to call them and ask for assistance. If it is the patient's insurance carrier, you may need to send your claim via paper simply to get it outside of an electronic system.
 
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