Author Topic: reason for denial - please explain  (Read 2148 times)

Anne

  • Jr. Member
  • **
  • Posts: 78
reason for denial - please explain
« on: June 03, 2008, 10:37:04 AM »
From United health care - for CPT code 97265 - says ACTIVE/VALID CPT/HCPCS & DESCRIPT-OR APPROPRIATE ASA/CPT4 ANESTH CODE

I looked up 97265 and it seems that code is no longer active, so I plan to resubmit using 97140 instead (tell me if that's NOT what I should do).  But in the explanation, I understand they are saying, I need to use an active CPT/HCPCS code, but what is ASA and why does it say ANESTH code.  And when I send in "reconsideration form" and corrected claims, along with EOB's, is it also necessary to send in medical notes? 

Thanks for your help,  you have a very helpful website.   ryanne

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4707
    • Solutions Medical Billing
Re: reason for denial - please explain
« Reply #1 on: June 06, 2008, 12:04:10 PM »
Hi,
   The 97265 code was deleted in 1999 and the 97140 is the replacement code.  So it sounds like you are correct in resubmitting with that code.  The denial you received is just a standard denial to cover many circumstances so you can ignore the anesth part.  Also, it is not necessary to submit notes when sending in a corrected claim, unless they had specifically asked for them.

Thanks
Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com