Results 1 to 5 of 5

Appeal Letter

  1. Default Appeal Letter
    Medical Coding Books
    Does anyone have a great insurance appeal letter they use for bi-lateral breast reconstruction when insurance companies decide not to pay accordingly to guidelines?

    If so please e-mail me to

    Thank you so very much!

  2. #2
    Milwaukee WI
    Default Short, Sweet, Specific
    Dear Insurance

    RE: patient, DOB, subscriber #, Group #, Claim #

    We are appealing level of payment for DOS / CPT / Description

    This procedure was performed bilaterally, and we appended the appropriate modifier(s).

    I enclose a copy of the operative report for your convenience. Please reconsider level of payment.


    Name, CPC

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Milwaukee WI
    Default One more thing
    Oh, I also clearly underline the appropriate areas in the op report that show right and left ... frequently using two colors of ink (for example red for Left, blue for Right)

    F Tessa Bartels, CPC, CEMC

  4. Default Appeal Letter for procedure
    Hi does any one know how can to write appeal letter denial for procedure because didn't obtain prior authorization for procedure, please any one advise, thanks Ana

  5. #5
    I would appeal it based on medical necessity.
    Donna Houston CPC
    Medical Biller and Coder
    ICD 10 Proficient

Similar Threads

  1. Auth Appeal Letter
    By desertcoder in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 02-25-2017, 12:06 PM
  2. Worker's Comp Appeal Letter
    By wmcodylee in forum General Discussion
    Replies: 2
    Last Post: 12-14-2014, 02:40 PM
  3. 20936 and 20930 Appeal Letter
    By MsAnna in forum Neurology/Neurosurgery
    Replies: 2
    Last Post: 05-30-2013, 09:59 AM
  4. appeal letter balloon
    By mburke81 in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 11-03-2011, 10:54 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.