Appeal

“Has anyone had CIGNA, Tufts, UHC reject CPT code 28310 (Akin osteotomy) as a separate and billable code with a Lapidus arthrodesis/hallux valgus correction with bunionectomy (CPT 28297)? I did appeal with CIGNA and was told that the nurse-coder looked at my appeal and related to me that according to the NCCI Edits, the Akin osteotomy is “part and parcel” included with a Lapidus arthrodesis/ bunionectomy. What is the next step?”

APPEALING MEDICARE DECSIONS Once an initial claim determination is made participating physicians generally have the right to appeal. Physicians who do not take assignment have limited appeal rights. Beneficiaries my assign their appeal rights to Physicians who provide them with services or items.