Author Topic: Unlisted Procedure Code Not Paying  (Read 501 times)

sheli2084

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Unlisted Procedure Code Not Paying
« on: April 20, 2020, 09:13:38 PM »
I have a case for a patient who had a lap sleeve done, code 43775 was billed/paid no problem.  2 days later the pt was back in the hospital with a perforation of the staple line for that sleeve.  Op note states this second procedure done as a "lap repair of gastric perforation and omental patch".  I coded it as 43659 for an unlisted lap procedure of the stomach and insurance keeps denying as "more appropriate code can be billed".  I have appealed twice with the op note and they continue to deny.  For the life of me I can't find another, more appropriate code.  The codes I find are either repairs of perforations done but caused/related by other issues such as ulcers, or obviously there are open procedure codes...Does anyone know something I am missing?

kristin

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Re: Unlisted Procedure Code Not Paying
« Reply #1 on: April 20, 2020, 11:34:54 PM »
Not my area of expertise, but what about 49329?

Medical Billing Forum

Re: Unlisted Procedure Code Not Paying
« Reply #1 on: April 20, 2020, 11:34:54 PM »