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Code 25609- effective date

  1. #1
    Default Code 25609- effective date
    Medical Coding Books
    A student in my class who is a biller has a problem with a worker's comp carrier for this code- 25609- it was denied- she was told the code was not valid until 10/18/07. the DOS on the procedure is Sept. 2007. I see the note for CPT Changes: Insider's view 2007- but do not have access to that. We would like to know if the adjustor is correct or should she appeal the claim?

  2. #2
    CPT 25609 became effective 1/1/2007 PER CPT, however, some state's Workers' Compensation do not update their fee schedule every year (in Nebraska it's done every other year) so you may have a valid CPT code but it is not valid for the WC Fee Schedule that was effective on the DOS.

    Hope this helps.

    Julie, CPC

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