Forum - Questions & Answers
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.
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.