Office visit.

Hi,

My provider is OB/GYN specialist, we billed CPT code 99244 with DX code 627.2 but insurance denied this services stating: Procedure code billed is not correct/valid for the services billed or the date of service billed and when we called they said that this is denied according to CCI edits but I'm not able to find any update related to this code. please advise what is wrong with Coding/Billing of this service. ALso please note that provider has spent 60 minutes with pt. and service fulfill all three componenet required for this service.

Sep 23rd, 2009 -

Did they request records?

Perhaps they saw no request for consult or no evidence report sent to requesting doctor

Sep 28th, 2009 - Codapedia Editor 1,399

what else did you do that day?

Was another service provided, such as a biopsy? If so, the E/M would need a modifier.

I am surprised that they denied it due to CCI edits, if only one service was done.

Sep 28th, 2009 - bigdog40 27

Office Visit

Did you attach the requesting provider (including NPI#) name? This was a consultation code. If he was not seeing the patient for another doctor you should not use that code.