Wiki Urogynecology denial

[ecushing]

57425, 57423, 58571, 57288, 52281, 56800 were coded. 57423 was denied, and insurance is trying to recoup payment on 56800 saying repair of introitus was not performed, rather a perineorrhaphy. Looking through medical notes, there was a perineorrhaphy without rectocele. 57423 was also denied. Trying to use 57260 in place of 56800. Not sure why 57423 was denied. I'm taking over for a long time biller, and was handed a huge stack of denials.

 

[nickelclaw]

Kind of hard to help without note.
The 57260 is anterior posterior repair-which means cystocele and rectocele. But you said no rectocele was done but a perineorrhapy was. Was a cystocele repair done too?
If just a cystocele was done with or without urethrocele includes the cystourethroscopy is 57240.
52281? was a ureteral stenosis dilated