Mary Posted Wed 13th of July, 2011 20:26:09 PM
we have received a denial and the eob code is 4714 which states age to procedure conflict-can anyone help with this explanation-the test done was a sed rate and we had the correct dx and patient's age is correct-could it be the CPT code?
SuperCoder Answered Thu 14th of July, 2011 04:58:28 AM
plz submit the details of info
Mary Posted Thu 14th of July, 2011 12:34:06 PM
Dear Sanjit-outpatient lab done was 85651-sed rate -patient is 57-we received "age to procedure code conflict" also "procedure code incompatible with diagnosis code" we had a dx code of 729.1 which according to LCD is covered-we are just baffled by this EOB (I should explain also that we are the coding department and are trying to assist the billing staff in finding out what this means). Thank you for any help.
SuperCoder Answered Thu 14th of July, 2011 13:34:32 PM
Sometimes the denial note or reason comes wrong most of the time in cases of Lab CPTs because of some other valid reasons. So, I needed another info: If any other CPTs billed on the same DOS? If yes, plz mention.
Mary Posted Thu 14th of July, 2011 14:27:23 PM
This was the only CPT code used-I believe we are just going to tell Business Office staff to call Medicaid for further clarification-thank you for your help!