Author Topic: Denial Code CO-107  (Read 14100 times)

mcrbiller

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Denial Code CO-107
« on: June 09, 2010, 09:51:31 PM »
I do medicare billing for a pain treatment center. I've been coming across the denial code C0-107 “Claim/service denied because the related or qualifying
claim/service was not paid or identified on the claim.” What exactly does that mean? How do I correct this? Any help will be greatly appreciated.

PMRNC

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Re: Denial Code CO-107
« Reply #1 on: June 10, 2010, 06:30:56 AM »
What was the procedures.
Linda Walker
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Michele

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Re: Denial Code CO-107
« Reply #2 on: June 10, 2010, 06:52:50 AM »
Procedures would help, but it sounds like there was another service billed before that includes the services you are billing for.  Can't be sure without knowing what you were billing.

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mcrbiller

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Re: Denial Code CO-107
« Reply #3 on: June 10, 2010, 08:08:46 AM »
CPT is 64483.

Anand

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Re: Denial Code CO-107
« Reply #4 on: June 10, 2010, 08:21:26 AM »
I think it should be bec of the missing Modifier. If done bilateral use the appropriate mod...

oneround

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Re: Denial Code CO-107
« Reply #5 on: June 10, 2010, 10:24:04 AM »
I believe Anand might have it coorect on this one



The series of codes 64479-64484 describes transforaminal epidural injections of an anesthetic agent and/or steroid. Transforaminal epidural spinal injection techniques are a different approach compared to central epidural injections. Because the vertebral artery as well as the spinal cord is in close proximity to the nerve root, the transforaminal injections are more difficult to perform.

The code descriptors identify the spinal anatomy, the substances injected and the spinal level(s) involved. CPT codes 64479-64484 are unilateral procedures. Therefore, when bilateral
transforaminal epidural injections are performed, the modifier -50 should be appended.

Also, is this the only code that you are using?
« Last Edit: June 10, 2010, 10:27:49 AM by oneround »
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

mcrbiller

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Re: Denial Code CO-107
« Reply #6 on: June 10, 2010, 11:55:54 AM »
Sometimes the claim is billed out using 64483 and 64484. Sometimes it's billed w/fluoro(77003) and sometimes without. Some claims pay and some don't.

oneround

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Re: Denial Code CO-107
« Reply #7 on: June 10, 2010, 12:03:25 PM »
These codes can be reported together as the 64484 is an additional code: 64483 Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level 64484 Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, each additional level (List separately in addition to code for primary procedure)

Also, on the fluoro are you attachinbg Mod 59?  Also remember that  77003 is intended to be reported per spinal region (eg, cervical, lumbar) and not per level.

You should be able to appeal those denials
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

mcrbiller

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Re: Denial Code CO-107
« Reply #8 on: June 10, 2010, 01:11:25 PM »
Thank you all for the advice. I'm going to correct these and rebill.