Author Topic: Denial of CPT 11106  (Read 1033 times)

trisha426

  • Newbie
  • *
  • Posts: 9
Denial of CPT 11106
« on: October 15, 2019, 05:49:27 PM »
Recently Medicare and BCBS are denying CPT 11106 in our ASC. These codes are being billed with excision codes but modifiers are being used to show that they are separate locations. Does anyone have an answer or should we not be billing this CPT in an ASC setting

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 5813
    • Solutions Medical Billing
Re: Denial of CPT 11106
« Reply #1 on: October 16, 2019, 09:16:02 AM »
What are they denying them for?  Reason? 
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

trisha426

  • Newbie
  • *
  • Posts: 9
Re: Denial of CPT 11106
« Reply #2 on: October 17, 2019, 10:38:34 AM »
151- payment adjusted because the payer deems the information submitted does not support this many/frequency of services. It was only 1 biopsy coded with 14060 using an XS modifier. The doctor was paid but not the ASC for 11106

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 5813
    • Solutions Medical Billing
Re: Denial of CPT 11106
« Reply #3 on: October 21, 2019, 09:53:31 AM »
Have you contacted them to ask for an explanation?  It sounds like it's hitting up against something but not on your bill.  I would start by calling and having them take a look to see if the claim was processed correctly.
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

trisha426

  • Newbie
  • *
  • Posts: 9
Re: Denial of CPT 11106
« Reply #4 on: October 21, 2019, 11:45:23 AM »
thank you

Medical Billing Forum

Re: Denial of CPT 11106
« Reply #4 on: October 21, 2019, 11:45:23 AM »