Why Is Aetna Medicare Denying J1010 Methylprednisolone With Nerve Block Codes?
A J1010 methylprednisolone denial from Aetna Medicare as non-covered usually follows the nerve block line, not the drug. Since October and November…
AAPC Answer
Why Is Humana Denying 87811-QW and 87804-59-QW for Rapid COVID and Flu Tests?
An 87811 87804 modifier QW 59 denial from Humana usually means one combo test was split into separate codes. Since January 1,…
How Should a Lab Respond When a Payer Challenges Toxicology Code Bundling?
A toxicology bundling denial on G0483, 80307, or G0480 to G0482 usually means the payer folded your lab test into the treatment…
Why Is 33361 With Modifier 62 Denying for a Missing or Inconsistent Modifier?
A 33361 with modifier 62 denying for a missing or inconsistent modifier usually means Medicare also expected modifier Q0. For TAVR dates…
Why Is Blue Cross Denying ASC Nerve Block Codes as Bundled, Even With Modifier 59?
Nerve block ASC denials from Blue Cross usually mean the block code hit a bundling edit against the surgery. For 27447 with…
Has Anyone Successfully Gotten Paid for the 3rd Level of Nerve Blocks or RFAs?
Getting paid for the 3rd level of nerve blocks or RFA is rare under Medicare. Its billing articles treat a third level…
Why Is Aetna Denying an Office Visit (99213) When Billed With an X-Ray?
Aetna denying 99213 billed with an x-ray usually means the E/M line is missing modifier 25. Fix it by appending 99213-25 when…
Florida Medicaid VFC Vaccine Denials (CARC 16, M51, N111): Bill Two Lines per Vaccine
Florida Medicaid wants two codes for every vaccine you give. One is the vaccine product code. The other is the administration code,…