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33225 denied

  1. Question 33225 denied
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    Hi everyone,

    My Dr. billed:

    33249
    33225-53
    33233-51
    33223-51
    71090-26
    36005

    Payer is denying 33225, can anyone tell me why? It is unclear to me

  2. #2
    Default
    Quote Originally Posted by coders_rock! View Post
    Hi everyone,

    My Dr. billed:

    33249
    33225-53
    33233-51
    33223-51
    71090-26
    36005

    Payer is denying 33225, can anyone tell me why? It is unclear to me
    Well, for one, you've got a discontinued procedure modifier on it - usually they want records for those. I can't see any other reason to deny it, though.

  3. #3
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by coders_rock! View Post
    Hi everyone,

    My Dr. billed:

    33249
    33225-53
    33233-51
    33223-51
    71090-26
    36005

    Payer is denying 33225, can anyone tell me why? It is unclear to me
    I agree with Brandi, the 53 modifier could be the issue. I also consider 36005 inherent to the procedure and not separately billable. Did the payor reimburse for 36005?

    HTH
    Danny L. Peoples
    CIRCC,CPC

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