CPT 20697

Hi, I have two denials- one from UHC HMO & one from UHC Community Plan for CPT 20697- Application of multiplane (pins or wires in more than 1 plane)- stating this is a "Technical Component only" & cannot be billed for the professional services. We do not understand why this is so since this code doesn't have a professional/technical component & we have spoken to several customer service reps at both insurance co's & the Provider Service Reps as well but no one can clarify this other than saying this is not a covered service for the professional billing. Does anyone have any clarification on this? We have sent appeals but they have come back denied as well. Thanks so much!!

Comments

  • edited May 2017
    Can you give me the patient and DOB so I can look to see if this was coded correctly.


    Kimberly Nedley, CPC
    Certified Coding Specialist II
    UPMC Health Services Division
    Quality Assurance Program
    Quantum One Bldg
    2 Hotmetal Street W112
    Pittsburgh, PA 15203
    PH... 412-432-5326 (M/W)
    Cell PH 412-370-1328 (Tu/Th/F)
    nedleykl@upmc.edu
  • edited May 2017
    I apologize - did not mean to reply to this email


    Kimberly Nedley, CPC
    Certified Coding Specialist II
    UPMC Health Services Division
    Quality Assurance Program
    Quantum One Bldg
    2 Hotmetal Street W112
    Pittsburgh, PA 15203
    PH... 412-432-5326 (M/W)
    Cell PH 412-370-1328 (Tu/Th/F)
    nedleykl@upmc.edu
  • Error in sending this email - Sorry
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