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incidental?

Barbara Posted Tue 30th of August, 2011 13:01:25 PM

Hi Group,
my doc say a pt in ER, did 31575 and 92511 (pt c/o of chicken bone in throat. DR brought pt to OR - performed 31530 and 43200.
billed this way - 99284-57
31575
92511-59
31530
43200-59 Now BCBS is recouping $$ stating that 92511 and 31575 are inclusive to 43200.
any help is appreciated.

SuperCoder Answered Tue 30th of August, 2011 14:39:15 PM

The CCI edits do not allow 92511 and 31575 to be billed with 43200. BCBS is right in this context.

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