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ankle surgeries denying

  1. #1
    Default ankle surgeries denying
    Medical Coding Books
    i code for podiatry in ohio and recently have started receiving denials for my podiatrist performing ankle surgeries. this is happening with MCD and MCR only. they are denying bimalleour fracture care codes along with other ankle surgery codes.
    they are denying for "procedure out of realm of speciality". i have appealed 4+ of these for the same reason. i have sent in the podiatrist taxonomy showing they are a foot and ankle surgeon, an article from boulder medical center stating what a podiatrist is, and the operative note in from the physician.
    after sending all of this information in the insurances are still denying, i have only been able to get one of these paid.
    i was wondering if anyone else has been having issues with podiatrist getting paid for ankle surgeries? how are you appealing these? are they getting payment after appeal?
    thanks in advance.

  2. #2
    Location
    Columbia, MO
    Posts
    12,913
    Default
    Did you credential your provider as a foot and ankle surgeon or as a podiatrist?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    i have one podiatrist who is cred. as a podatrist and one that is cred. as a foot and ankle surgeon.

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