Line Item Denials
We had a MRI charge denied from an inpatient claim which was a cost outlier. The reason stated was patient had hx of pacemaker and MRIs are contraindicated. We did not code hx of pacemaker/AICD and a pacemaker is not documented as being present anywhere in our medical record i.e. EKGs, consults, H&P, nursing notes, etc. This is a small charge in the big picture but I am just curious if others have run into items being denied for reasons such as this.
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