Medical Billing Forum
Billing => Billing => : TXBiller February 07, 2020, 07:44:06 AM
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Can someone please help me figure this out? I don't understand what it's telling me.
OV 99214 received CO-97 with remark N19 from BCBS of Texas
CO-97 Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
N19 Procedure code incidental to primary procedure
TIA
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What other service was billed on the DOS?
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Yes, we need to know the other services billed.
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A CO-97 denial code means that the line item denied is being bundled into another service rendered on that same DOS, or another service from a previous DOS that the patient is in a global period for. If the line item that denied is unrelated to services on that same DOS, or previous DOS, and can be billed separately, then a modifier is needed to indicate this. But as others said, without knowing what else was billed, there is no way to advise you on what to do next.