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69631 on left ear, 69610 on right ear

Francisco Posted Tue 18th of December, 2012 16:06:09 PM

Surgery done: '69631-LT' on left ear, and additional procedure '69610-51-RT' done on right ear. Insurance denied second procedure, saying it is a subset of the first procedure. I disagree, and felt my coding showed the second procedure was not related to the first procedure. Am I missing something, or have I coded improperly? Or is an appeal the only way? Please help

SuperCoder Answered Tue 18th of December, 2012 20:27:55 PM

You are correct in your approach, since the ears are different. Both will be reported. You have to appeal regarding this mentioning different ears.

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