Podcast
Play an AI-generated podcast conversation about this lesson
Questions and Answers
What action should be taken if BCBS denies a claim for CPT code 76514 with modifiers RT/LT indicated?
What action should be taken if BCBS denies a claim for CPT code 76514 with modifiers RT/LT indicated?
- Contact BCBS to confirm if the service is covered under the patient's plan
- Submit the claim with different modifiers for reconsideration
- Submit the claim without any modifiers added (correct)
- Bill the patient directly for the service
What action should be taken if CPT code 92250 is denied with the reason 'mutually exclusive procedure/s cannot be done on the same day/setting' when billed with CPT codes 92134 or 92133?
What action should be taken if CPT code 92250 is denied with the reason 'mutually exclusive procedure/s cannot be done on the same day/setting' when billed with CPT codes 92134 or 92133?
- Appeal the claim with medical records if modifier 59 is already present on CPT code 92250 (correct)
- Write off the claim as a disallowance and note the account details
- Add modifier 59 to CPT code 92250 and submit a corrected claim
- Inform the co-lead or lead if the appeal is denied or denial is upheld
When CPT code 92250 is billed with CPT codes 92134 or 92133, what should be done to prevent a denial?
When CPT code 92250 is billed with CPT codes 92134 or 92133, what should be done to prevent a denial?
- Appeal the denial with the insurance company
- Append modifier 59 to CPT code 92250 and send a corrected claim (correct)
- Remove CPT codes 92134 and 92133 from the claim
- Do nothing, as the denial is expected
What should be done if CPT code 92250 is billed with modifiers 52LT or 52RT and a denial for 'required modifier is missing' is received?
What should be done if CPT code 92250 is billed with modifiers 52LT or 52RT and a denial for 'required modifier is missing' is received?
Signup and view all the answers
If BCBS sends a denial stating 'prior processing information appears incorrect' when a corrected claim is submitted, what does this indicate?
If BCBS sends a denial stating 'prior processing information appears incorrect' when a corrected claim is submitted, what does this indicate?
Signup and view all the answers
