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surgery denials for cscope,egd and exc lesion face

  1. Default surgery denials for cscope,egd and exc lesion face
    Medical Coding Books
    We received a denial from B/C for 45378 cscope and 43239-51 egd also 11441-51 was done at the same time. the denial was on the 11441 based on (cci)correct coding initiative. has any one had this problem before?

  2. #2
    Johnson City
    I checked these codes out on the NCCI edits, and McKesson Clinical Editing, and found it should be a payable coding combination. I would appeal it. Print out the section of the CCI edits that shows code 45378, 43239, in column one as proof that code 11441 is not listed there. I'm not sure what carrier you are dealing with, but some have a special clinical editing appeal form to use for these situations.

    Hope this helps.
    Melissa Jewett, CPC

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