Forum - Questions & Answers
multiple procedure denial
HELP!! I work in a family practice and the doc removed 7 lesions in various locations on a patient's back. Unfortunately, he didn't document exactly where, as in, R or L side. 5 of the lesions are 11300 and the other 2 are 11402 based on size and location. The 2 11402 were sent to pathology and came back with ICD9 of 216.5. That is the code he selected for the others, as well. I sent the claim with 2 lines as follows:
11402 with 2 units and 11300 with 5 units. The 11402 were paid and 3 of the 11300 were paid with 2 being denied with remark code of "payment adjusted because the pater deems the information submitted does not support this many/frequency of services.
Should I have entered them line by line with 59 modifier on all of them? Or any other help would be appreciated. Thanks in advance