What is OA 23 Adjustment code mean?
OA-23: Indicates the impact of prior payers(s) adjudication, including payments and/or adjustments. No action required since the amount listed as OA-23 is the allowed amount by the primary payer.
What is the denial code for timely filing?
Insurance will deny the claim with denial code CO 29 – the time limit for filing has expired, whenever the claims submitted after the time frame. The time limit is calculated from the date service provided.
What is a reason code in medical billing?
Reason codes appear on an explanation of benefits (EOB) to communicate why a claim has been adjusted. If there is no adjustment to a claim/line, then there is no adjustment reason code.
What is the medical coding modifier for HCPCS?
A medical coding modifier is two characters (letters or numbers) appended to a CPT ® or HCPCS Level II code. The modifier provides additional information about the procedure, service, or supply involved without changing the meaning of the code.
What is the appending modifier for medical code 59?
Appending modifier 59 signifies the code represents a procedure or service independent from other codes reported and deserves separate payment. Like modifier 25, modifier 59 is difficult to master because it requires determining whether the code is truly distinct and separately reportable from other codes.
What are the medical coding modifiers for NCCI?
Table 1: NCCI PTP-Associated Modifiers Modifier Abbreviated Description 57 Decision for surgery 58 Staged/related postoperative procedure 78 Unplanned postoperative return to the op 79 Unrelated postoperative procedure
What is the CPT code set for unrelated procedures?
Modifier 79: Unrelated Procedure For unrelated procedures during the postoperative period, the CPT ® code set provides modifier 79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period.