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Secondary Payor Doesn’t Recognize Consultations
We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However, Cigna is refusing to process the claim since they no longer pay for consult codes. Am I allowed to change the CPT code and rebill Cigna? Or would I need to change the CPT, refile to the primary as a corrected claim, then send the balance on to Cigna?
Secondary Payor Doesn’t Recognize Consultations
We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However, Cigna is refusing to process the claim since they no longer pay for consult codes. Am I allowed to change the CPT code and rebill Cigna? Or would I need to change the CPT, refile to the primary as a corrected claim, then send the balance on to Cigna?
E/M Visit During the Global Period
Can I bill an office visit in the global period if the diagnosis is different from why I did the original procedure?
Coding Mesh Placement in Hernia Repairs
If mesh is placed for a laparoscopic hernia repair can an unlisted code be reported for the mesh placement?
Stent and Embolization Coil Used in Same Session
The surgeon used a stent and then inserted an embolization coil for an aneurysm. Are both billable?
Excisional Debridement Two Fractures:
Our surgeon treated a patient who presented with an open fracture of the distal tibia and fibula. The surgeon performed an excisional debridement down to and including the bone removing devitalized tissue and gravel and other debris that imbedded into the open fracture site. Is CPT code 11012 reported twice for debridement of the tibia and fibula?
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