A biopsy should be considered medical, its a medical procedure no matter if its and ENT or oral surgeon who does it. Its possible that the coding is not correct which would cause the claim to get rejected.

I hate to say it but it sounds to me like this is going to be back and forth with no quick and easy fix. Dont give up! Keep appealing! You may need to send letters from the OS stating exactly what was done with correct codes and resubmit the claim. When talking with the insurance company be sickening sweet to whoever you speak to, it really does help.

Good luck!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile