My health insurance might be able to cover a surgical procedure needed. But the codes submitted on the treatment proposal aren't covered. It was implied that if the office had a different code for the procedure, the insurance company may cover it. The doctors office aren't helping in getting the correct codes. So, how can I get a list of medical codes to check myself?
Asked by Anonymous at 5:29 PM on Jan. 25, 2010 in Health
Answer by PrttyMstng at 6:12 AM on Jan. 26, 2010
Answer by Anonymous at 5:38 PM on Jan. 25, 2010
no. that's illegal and not what i want to do. the surgery is dental but its caused by a genetic disorder which is medical. so because the doctor is listing it as dental surgery the insurance won't cover it. but i was told by the insurance company that if the office changed the code to the medical side that they would possibly cover it. but then i spoke to the dr office and they keep telling me to go the the insurance company. which sends me back in a circle. i just want to assist in the receptionist doing her job since she won't do it.
Answer by Anonymous at 6:18 PM on Jan. 25, 2010
also, she's using the code for pulpotomy. and it's not. pulpotomy is nerve treatment that's not the procedure i'm having.
Answer by Anonymous at 6:31 PM on Jan. 25, 2010
Answer by Anonymous at 3:03 AM on Jan. 26, 2010
Answer by Anonymous at 3:05 AM on Jan. 26, 2010
Answer by Anonymous at 3:20 AM on Jan. 26, 2010
Many times the same procedure will have different codes with just slightly different meaning. It isn't that you are summiting a code for a different procedure. Often doctors office just summit the same code all the time even if it doesn't exactly fit what you are having done. The only place to find what is covered is through the insurance company. Ask them if a procedure is covered and what codes are acceptable, they may tell you. I would not summit any codes that do not match the procedure you had done.
Answer by RyansMom001 at 6:22 AM on Jan. 26, 2010
Answer by PrttyMstng at 7:47 AM on Jan. 26, 2010