Jan 18th, 2016 - petunia 195
re: correct Procedure code
You should never ever code to get paid. If there is no code that represents the procedure you are doing you should use an unlisted code. Unlisted codes are almost always denied because they are carrier priced codes which means you will need to appeal any denials with operative and any other notes that help your case. Typically the carrier will pay based on documentation and Med necessity. It also helps to have a comparable CPT® code (something comparable to what was done) to help process the claim. We have had great success with payments using the appropriate method and CPT® code.