downgrading by bundling codes

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dkennel
Posts: 24
Joined: Thu Jun 28, 2012 6:13 pm

downgrading by bundling codes

Post by dkennel » Sun May 29, 2016 5:15 pm

One of the common practices of my third parties is to downgrade multiple one surface restorations on one tooth to a single 2 surface restoration. on our EOB the charges for the single surface codes are denied, but the insurance replaces them with a single code for a multi-surface restoration. Similar bunding has happened with multiple x-rays, individual codes are denied and instead reimbursed as one code for intraoral series.
What is a good strategy for entering this payment in the claim/account? I dont think I can enter a code just for payment if I have not billed it? I cannot change the code number billed or rather bundle codes in the claim?
Would the correct fix be a feature request? Or is there a strategy or function I am not using?

Thanks,

Dietmar

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