Forum - Questions & Answers
Workers' Comp denial
I just recieved an denial on CPT: 99212 stating this is a non-covered charge? asked since when and why and of course got an answering machine. Anyone?
re: Workers' Comp denial
I can't imagine. What diagnosis code did you use?
re: Workers' Comp denial
I know- they know that no doctor in their right mind would charge only a 99212 on a workmans comp patient. The counseling and coordination with the insurer always gets these to 99213 at least. A 99212 is a mole check - you dont even get to touch the patient.
re: Workers' Comp denial
724.4 and 722.10, patient was scheduled for surgery in Jan. but there was a dispute and settled....so this was a followup visit to move foward with surgery. The rep I spoke to didn't say it was diagnosis related it was that 99212 is non-covered charge...basically repeating what the EOB states.
re: Workers' Comp denial
It is unusual for a work comp visit to only be a level 2, but it can happen. If you're sure it's related to the work comp injury, I would appeal with office notes.