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Wiki 93294 denials for payment already made for same/similar procedure within set time frame (but there hasn't been?)

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JRhea0715

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Sutherlin, OR
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We are seeing MCR denials for 93294 due to "payment already made for same/similar procedure within set time frame". We haven't billed any other pacer related charges within the last 90 days (not 93294/88/81/80/79). I noticed on a few, we've had 93280 that were billed 91+ days prior, but that is it. Anyone have any insight on this situation? I've scoured the LCD/NCDs and my usual sources. Thank you in advance.
 
Is there any chance one of the same/similar procedures were performed by a provider who is not in your medical practice or health system?
 
CBLENNIE said:
Is there any chance one of the same/similar procedures were performed by a provider who is not in your medical practice or health system?
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I suppose so? I'm not sure how we would be able to discover that information. Any ideas?
Our facility usually has a schedule of when these remote interrogations will happen, so that they know they are not performing them until after 90 days has passed. I don't know why or how, but I suppose it's possible that another provider in a different location/practice has performed a remote interrogation for the patient, without our knowledge.
 
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