Medicare issue
Tracy Fields
Description
Collection
Title:
Medicare issue
Creator:
Tracy Fields
Date:
4/27/2022
Text:
HELP!!! Where do I go or who do I talk to from here?
I have a claim for a preparatory BK prosthesis that keeps denying as the
procedure or service is inconsistent with the pt's hx and procedure code is
not correct/valid for the services billed or the date of service billed.
They paid for the foot and the liners no problem but denied my base code
and addition codes.
I have confirmed these codes inside and out. They are the basic prep codes
that we bill almost all day every day. I removed the K mods at one point to
see if that helped because for these codes they are not required to be on
the claim. That did not help either. I have added narratives to indicate
the claim is coded correctly and still denied. I dropped it paper and added
the narrative to see records attached confirming his amputation due to
having multiple surgeries within a few days of eachother starting with toes
and leading to the full amputation of the leg below the knee to confirm
that my codes are still correct, still denied (do not know if they even
looked at them).
I have no appeal rights on this claim to ensure someone looks at it. I know
there was another provider on here that sent an email indicating that he as
well has had two claims that this happened to. I think there may be an
internal error happening.
What other processes are there to get assistance with this claim? Yes, we
want our payment but also for the pt because how can anyone continue to
provide services if they know it will be denied due to this.
Thank you
*Tracy Fields*
Billing Specialist
*First Step Prosthetics*
*Kentucky Location:*
1136 US 31W Bypass, Bowling Green, KY 42101
Phone 270.904.6130 / Fax 270.721.0749
*Tennessee Location:*
179 Hancock Street, Gallatin, TN 37066
Phone 615.461.8557 / Fax 615.461.8581
Email: <Email Address Redacted>
This facsimile/email transmission contains information, which is
confidential and/or privileged. This information is intended for use only
by the addressee indicated above. If you are not the intended recipient,
please be advised that any disclosure, copying, distribution, or use of the
contents of this information is strictly prohibited, and that any
misdirected or improperly received information must be returned to this
company immediately. Your cooperation in contacting the sender regarding
the erroneous receipt is requested.
I have a claim for a preparatory BK prosthesis that keeps denying as the
procedure or service is inconsistent with the pt's hx and procedure code is
not correct/valid for the services billed or the date of service billed.
They paid for the foot and the liners no problem but denied my base code
and addition codes.
I have confirmed these codes inside and out. They are the basic prep codes
that we bill almost all day every day. I removed the K mods at one point to
see if that helped because for these codes they are not required to be on
the claim. That did not help either. I have added narratives to indicate
the claim is coded correctly and still denied. I dropped it paper and added
the narrative to see records attached confirming his amputation due to
having multiple surgeries within a few days of eachother starting with toes
and leading to the full amputation of the leg below the knee to confirm
that my codes are still correct, still denied (do not know if they even
looked at them).
I have no appeal rights on this claim to ensure someone looks at it. I know
there was another provider on here that sent an email indicating that he as
well has had two claims that this happened to. I think there may be an
internal error happening.
What other processes are there to get assistance with this claim? Yes, we
want our payment but also for the pt because how can anyone continue to
provide services if they know it will be denied due to this.
Thank you
*Tracy Fields*
Billing Specialist
*First Step Prosthetics*
*Kentucky Location:*
1136 US 31W Bypass, Bowling Green, KY 42101
Phone 270.904.6130 / Fax 270.721.0749
*Tennessee Location:*
179 Hancock Street, Gallatin, TN 37066
Phone 615.461.8557 / Fax 615.461.8581
Email: <Email Address Redacted>
This facsimile/email transmission contains information, which is
confidential and/or privileged. This information is intended for use only
by the addressee indicated above. If you are not the intended recipient,
please be advised that any disclosure, copying, distribution, or use of the
contents of this information is strictly prohibited, and that any
misdirected or improperly received information must be returned to this
company immediately. Your cooperation in contacting the sender regarding
the erroneous receipt is requested.
Citation
Tracy Fields, “Medicare issue,” Digital Resource Foundation for Orthotics and Prosthetics, accessed May 19, 2024, https://library.drfop.org/items/show/255872.
