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Pediatric Coding Alert

You Be the Coder:

Check Contract, Then Bill Patient

Question: We would like to know when an insurance company denies a procedure and states “denied- not a covered benefit,” should the EOB stipulate whether the patient can be billed for this procedure? For instance, patient came in for a well visit and had the visual acuity screen done. We bill a CPT code 99173 with an ICD-9 code V20.2 [...]