CPT copyright 2016 American Medical Association. All rights reserved.
Figure B-8. Sample Denial Tracking Tool
See www.aap.org/cfp for an online version of this tool (access code AAPCFP22).
Codes Paid When Submitted as a
Clean Claim
Payer
Name
Payer
Name
Payer
Name
Payer
Name
Payer
Name
Payer
Name
Payer
Name
Payer
Name
Example: 90460/90461;
90471/90472: Immunization
admin codes
Yes
Example: 992__ with preventive
medicine visit (9938_/9939_)
on same DOS
No
Example: Normal newborn care
or hospital visits/discharges
when billed with circumcision
Example: 92551 Hearing screen No, adj
off
Key: Yes = paid; No = no payment, appealed; Varies = payment is specific to employer’s benefit plan; No, adj off = billed, denied, NO APPEAL, based on contract,
adjust off.
Figure B-9. FAQ: Alternative Payment Methodologies (online only)
Found at www.aap.org/cfp, access code AAPCFP22
Figure B-10. Claim Correction Form (online only)
Found at www.aap.org/cfp, access code AAPCFP22
Previous Page Next Page