“I'm in PA, and this is an 80-year-old patient..... Cigna denied both charges stating the diagnosis codes do not support the procedure (as per what my billing company told me). This was before we were notified that notes must be sent in with all Cigna claims where an E&M is billed with a procedure.
“I am looking for clarification regarding dispensing a post-operative shoe in conjunction with performing a surgery (days before surgery, day of surgery or days following surgery). Can we have patients pay out of pocket for the device? Does the payer, Medicare or commercial carriers, factor into the rules?”