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69620, 69145, 69205 inclusive

Kristin Posted Mon 09th of January, 2012 19:09:42 PM

Is CPT 69205 inclusive to CPT 69620 & CPT 69145. We have a lot of insurance companies that say that it is. Please send me supported documentation so that I can appeal my denials. Thanks

SuperCoder Answered Tue 10th of January, 2012 19:12:38 PM

You can take a CCI edits copy of these code combinations, the result can be obtained in the form of adobe file format. This file can be sent to Insurane on appeal.

Kristin Posted Tue 17th of January, 2012 15:57:23 PM

We have done this and they are still denying saying it is inclusive.

SuperCoder Answered Wed 18th of January, 2012 11:03:08 AM

I have also checked the RUC database and the values for the main producers do not include the denied procedures. Barbara Cobuzzi has already sent the 31002 bundle to the attention of the CPT editorial board member’s ENT representative. I will send him the 69205 issue.

Also, are you making sure to link 69205 to the FRB diagnosis rather than 69620's OM diagnosis and 69145's neoplasm or Cholesteatoma ICD-9 code?

Jen Godreau, CPC, CPMA, CPEDC
Director of Development & Operations,

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