Medical Billing Forum
Payments => Insurance Payments => : catooch December 23, 2008, 03:22:58 PM
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Hi Michele,
I'm in a small chiro office and I just received a denial for a patient that we received authorization on. When we sent out the claim it got denied because they said it didn't support the info that we send. The only thing I can think of is the pt came in with the usual lumbar pain but also presented with a sprained ankle which was shown on the auth paperwork.
Nowhere on our claim did we refer tto this ankle sprain. Is that why they denied? If so, is there a modifier or some other codes we should have used.?
We billed 847.2, 739.3, 728.85, 724.2 with 99214, 97535, 98941, G0283, 97010.
Thanks, Cathy
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You shouldn't have to indicate the ankle since DC's aren't suppose to treat extremities anyway. It sounds more like they are looking for notes/documentation. Even though you received authorization, they may request notes. I would try calling to see what exactly they are looking for.
Michele
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Thank you Michele for quick response. Happy Holidays............
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Thanks! :) I'm enjoying them so far.
Michele