CPT copyright 2015 American Medical Association. All rights reserved. YOUR CODING TOOLKIT ||||||||||| 413 Appendix B Figure B-8. Sample Denial Tracking Tool See www.aap.org/cfp for an online version of this tool (access code AAPCFP21). 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.
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