When Billing Code 90714 Isn’t Recognized

When Billing Code 90714 Isn’t Recognized

In medical billing, code recognition is not the only reason for denial. 90714 is a new medical billing CPT code. If this code is denied, make sure you get the full story. In medical billing, code recognition is not an acceptable reason for denial.

When new medical billing codes are introduced there is a lag period that lets coders and payers get adjusted for that specific code. HIPPAA sets an effective date for all medical billing codes that states when companies must begin using the codes or accepting the new codes. It is illegal to deny claims for no recognition if the code effective date has passed.

There are instances in medical billing where code no recognition is acceptable. A payer can deny a claim with a new code if the effective date has not yet passed. If HIPAA released a code on January 1, but deemed the effective date to be March 1, then the payer doesn’t have to recognize the code until March 1.

Another big reason for denial is no coverage. If a payer rejects your new medical billing code, many times the rejection is due to no coverage. Don’t jump to the conclusion that the company doesn’t recognize the code.

If you find that an insurance company is wrongfully denying your medical billing claims due to wrongful no recognition, there is something you can do. Since HIPAA makes this no recognition illegal, you should register a complaint against the insurance company. These companies should not be allowed to play medical billing games. It wastes valuable time and money.

These medical billing denials can easily slip through the cracks if your personnel are not adequately trained. Medical billing firms can guarantee these denials are not overlooked. These companies will make sure your services are not denied due to illegal medical billing practices.

View all Articles by: Melissa Clark, CCS-P