Forum - Questions & Answers

Sep 19th, 2012 - Cadvas

Inpatient Echo readings Denied

We are receiving denials for Echo's (93306,26) when billed on the same day as an IP E/M code. It is mainly from BCBS and the reason stated C097: The benefit for this service is included in the payment/allowance for another service procedure that has already been adjudicated, and N19:, Procedure code incidental to primary procedure.
Has anyone else had this issue and how was it resolved? Thanks.

Sep 20th, 2012 - Codapedia Editor 1,399 

re: Inpatient Echo readings Denied

When they use the word "incidental" that usually means they aren't following NCCI edits, but are using their own proprietary edits.

I would print out NCCI edits and appeal. Your physician may have to write to the medical director.



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