The following codes were submitted to a private insurance co…
The following codes were submitted to a private insurance company for reimbursement for an established patient with insulin dependent diabetes mellitus who was seen in the office. The patient had a blood test to check his glycosylated hemoglobin (A1c) level and a detailed history and a physical examination (level 4 Evaluation and Management service) for circulatory problems. Diagnosis Codes Submitted to insurance: D51.0 (pernicious anemia) CPT 99214 level 4 established patient EM service CPT 83036 glycosylated(A1c) hemoglobin This insurance claim would most likely be denied due to which of the following reasons?
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