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code question

Rana Posted Wed 04th of December, 2019 15:23:10 PM
i billed bcbs 66982 dx h25.12 65420 51 LT dx H11.022 65875 59 LT DX H21.542 THEY PAID AND NOW THEY RECOUPED ALL PAYMENTS. HOW SHOULD I OF BILLED IT
SuperCoder Answered Thu 05th of December, 2019 04:48:02 AM

Hi Rana,

As per coding guidelines, codes selection is correct, procedure and diagnosis codes mapped correctly with modifiers. Since, extracapsular cataract removal has been performed on the left eye, so modifier LT can be appended with the CPT 66982. Also, as per RVUs values, pattern of the billing the procedure should be; 66982>65875>65420. For the payment recoupment, you can directly contact and clarify with the payer. You can check in the explanation of benefits statement for reason of recoupment of the payment. If find any discrepancy, correct it and re-bill the claim.

Hope this helps!

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