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MEDICARE DENIAL CO97

Nicole Posted Wed 13th of February, 2013 13:52:11 PM

We received a denial from Medicare co 97 stating that "the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated."

This was a lab on a patient. here are the cpt codes charged. It looks like thes can all be billed together an not bundled. Can you help us with why this might have been denied.
36415 Rev code 0300
80076 Rev code 0301
87088 Rev code 0306
87077 Rev code 0306
87186 rev code 0306
81001 rev code 81001
dx codes used 790.4 and 599.0

SuperCoder Answered Thu 14th of February, 2013 00:01:40 AM

We are working on this and will get back soon.

SuperCoder Answered Fri 15th of February, 2013 11:53:01 AM

Is the entire claim rejected? Or only a particular code(s)? There is indeed no CCI bundling between any of these codes.

Nicole Posted Tue 19th of February, 2013 02:55:36 AM

I am working on trying to find this out on what was exactly denied. Please let me get back to you.

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