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denial for procedure code 20600,advise for alternative

  1. #1
    Default denial for procedure code 20600,advise for alternative
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    Pt was scheduled for a f/u on chronic medical problems and during the visit new complaints were addressed and the provider did perform to separate injections
    1)Trigger finger Right Middle finger
    2)CMC Left thumb-M18.12
    Claim was coded
    99213-25
    20600-F7-M65.331
    20600-FA- 59 M18.12
    J3301 X2 units

    I did check NCCI edits (and Manual) and see only one unit of service can be billed and that modifiers are allowed
    This is obviously not a case where a joint and surrounding bursa's were injected
    Modifiers indicate separate anatomical sites for injections
    Unfortunately,our billing department has advised that no further action can be taken which doesn't make sense to me I honestly have little to no knowledge
    when it comes to billing .Reading other post it sounds like perhaps a paper claim could be submitted,or is that not correct?
    Is there something I missed when coding for the procedures
    I have reached out to the carrier and was advised that they are not coders
    I hate to see the loss of revenue for a service that was performed and documented well especially if I have incorrectly coded
    Appreciate advice

  2. #2
    Location
    Columbia, MO
    Posts
    13,253
    Default
    which code was denied? the entire claim? or just one line?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default denial
    Sorry, both Procedure CPT codes 20600 were denied ,the only thing that pd was $65 on the 99213

  4. Default
    Medical Billing
    I would have coded a trigger finger injection with a 20550 instead of a 20600? Not sure if that could be why they denied due to diagnosis not aligning with the procedure done?

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