PRESENTATION OUTLINE
MOST COMMONLY UNEXPECTED DENIED PROCEDURES FOR INTERNAL MEDICINE
36415 ROUTINE BLOOD CAPTURE
99214 OUTPATIENT DOCTOR VISIT, LEVEL 4
99233 SUBSEQUENT HOSPITAL CARE
99213 OUTPATIENT DOCTOR VISIT,LEVEL 3
93010 ELECTROCARDIOGRAM REPORT,0.24
TOP 5 REASON CODES ARE...
18: DUPLICATE CLAIM/SERVICE
97: BENEFIT FOR THIS IS INCLUDED IN PAYMENT/ALLOWANCE FOR ANOTHER SERVICE THAT IS ALREADY ADJUDICATED
16: CLAIM LACKS INFORMATION OR HAS BILLING ERRORS WHICH IS NEEDED FOR ADJUDICATION.
96: NON-COVERED CHARGES. AT LEAST ONE REMARK CODE MUST BE PROVIDED
22: THIS CARE MAY BE COVERED BY ANOTHER PAYER PER COORDINATION OF BENEFITS
VERIFY EACH CLAIM BEFORE SIMPLY ADJUSTING THE CLAIM OFF AS A DUPLICATE
DETERMINE SERVICE WAS PERFORMED ONLY ONCE ON GIVEN SERVICE DATE
SERVICE MUST BE PERFORMED MORE THAN ONCE ON GIVEN DATA
KNOWING THIS INFORMATION WILL ASSIST IN RESOLVING DENIAL QUICKLY & APPROPRIATELY.
