Forum - Questions & Answers
authorization for one procedure but another was performed what now?
We obtained a prior authorization for a 95810 & 95805 from insurance. The issue is that the patient had a 95811 and didn't need the 95805. The claim was billed as a 95811 and was denied by the insurance company. Is it possible to rebill the claim as a corrected claim as 95810 in order to get paid?
re: authorization for one procedure but another was performed what now?
When a different procedure is performed than the procedure authorized, you will need to immediately notify the payer and obtain a new authorization #. Was this done? If not, this is the reason your claim was denied. It would not be appropriate to bill a service not performed simply to obtain payment for billing service not authorized.